Provider Demographics
NPI:1437318532
Name:YEH, CHIA-CHEN (D,D,S/ MSD)
Entity Type:Individual
Prefix:DR
First Name:CHIA-CHEN
Middle Name:
Last Name:YEH
Suffix:
Gender:M
Credentials:D,D,S/ MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18195 VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-4302
Mailing Address - Country:US
Mailing Address - Phone:310-515-1108
Mailing Address - Fax:310-515-2838
Practice Address - Street 1:18195 VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-4302
Practice Address - Country:US
Practice Address - Phone:310-515-1108
Practice Address - Fax:310-515-2838
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36632122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABUS-0059416Medicaid