Provider Demographics
NPI:1457300097
Name:CHEN, ELLEN CHING (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:CHING
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:27699 JEFFERSON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2661
Mailing Address - Country:US
Mailing Address - Phone:951-252-8588
Mailing Address - Fax:951-252-8589
Practice Address - Street 1:36320 INLAND VALLEY DR
Practice Address - Street 2:SUITE 203
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7512
Practice Address - Country:US
Practice Address - Phone:951-200-2220
Practice Address - Fax:951-200-2221
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2014-06-19
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Provider Licenses
StateLicense IDTaxonomies
MA206639208000000X
CAC55688208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics