Provider Demographics
NPI:1366483497
Name:CHEN, HSIAO- FEN (MD)
Entity Type:Individual
Prefix:
First Name:HSIAO- FEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 798
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-0798
Mailing Address - Country:US
Mailing Address - Phone:626-307-0797
Mailing Address - Fax:626-307-0805
Practice Address - Street 1:140 W VALLEY BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3760
Practice Address - Country:US
Practice Address - Phone:626-307-0797
Practice Address - Fax:626-307-0805
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54242207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A542420Medicaid
CA00A542420Medicaid
CAWA54242CMedicare PIN