Provider Demographics
NPI:1396846432
Name:WEBER CHEN MEDICAL CORP
Entity Type:Organization
Organization Name:WEBER CHEN MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WEBER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-288-0008
Mailing Address - Street 1:1936 HUNTINGTON DR STE C
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-4859
Mailing Address - Country:US
Mailing Address - Phone:606-288-0008
Mailing Address - Fax:866-741-4630
Practice Address - Street 1:1936 HUNTINGTON DR STE C
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4859
Practice Address - Country:US
Practice Address - Phone:606-288-0008
Practice Address - Fax:866-741-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85444207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1679504393OtherINDIVIDUAL NPI
CAA85444OtherMEDICAL LICENSE
CAA85444AMedicare ID - Type Unspecified