Provider Demographics
NPI:1508887100
Name:CHEN, PETER CHAO-PANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:CHAO-PANG
Last Name:CHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:#490
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4504
Mailing Address - Country:US
Mailing Address - Phone:310-540-1405
Mailing Address - Fax:310-972-9646
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:#490
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4504
Practice Address - Country:US
Practice Address - Phone:310-540-1405
Practice Address - Fax:310-972-9646
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice