Provider Demographics
NPI:1417171505
Name:CHEN, WAYNE W (MD PHD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:W
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:WEIPIN
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 VIA LUCCA
Mailing Address - Street 2:F209
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612
Mailing Address - Country:US
Mailing Address - Phone:949-754-9389
Mailing Address - Fax:949-754-9330
Practice Address - Street 1:2601 CAMPUS DRIVE
Practice Address - Street 2:US LABS
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612
Practice Address - Country:US
Practice Address - Phone:949-754-9389
Practice Address - Fax:949-754-9330
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83106207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology