Provider Demographics
NPI:1477721199
Name:K. CHEN A P.C.
Entity Type:Organization
Organization Name:K. CHEN A P.C.
Other - Org Name:BEACH FAMILY & COSMETIC DENTAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-842-0601
Mailing Address - Street 1:17732 BEACH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6809
Mailing Address - Country:US
Mailing Address - Phone:714-842-0601
Mailing Address - Fax:
Practice Address - Street 1:17732 BEACH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6809
Practice Address - Country:US
Practice Address - Phone:714-842-0601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty