Provider Demographics
NPI:1417933243
Name:CHEN, EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 DOVER DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-5735
Mailing Address - Country:US
Mailing Address - Phone:949-645-4670
Mailing Address - Fax:949-722-6866
Practice Address - Street 1:601 DOVER DR
Practice Address - Street 2:SUITE 7
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-5735
Practice Address - Country:US
Practice Address - Phone:949-645-4670
Practice Address - Fax:949-722-6866
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75342208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics