Provider Demographics
NPI:1407045412
Name:CHEN, JULIE TAHLI (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:TAHLI
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2101 FOREST AVE STE 220A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1473
Mailing Address - Country:US
Mailing Address - Phone:408-295-8628
Mailing Address - Fax:408-295-8061
Practice Address - Street 1:2101 FOREST AVE STE 220A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1473
Practice Address - Country:US
Practice Address - Phone:408-295-8628
Practice Address - Fax:408-295-8061
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2009-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA96459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine