Provider Demographics
NPI:1518080530
Name:CHEN, DAVID YICHENG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:YICHENG
Last Name:CHEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17180 PATINA ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5700
Mailing Address - Country:US
Mailing Address - Phone:858-674-5701
Mailing Address - Fax:619-659-5738
Practice Address - Street 1:17180 PATINA ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-5700
Practice Address - Country:US
Practice Address - Phone:858-674-5701
Practice Address - Fax:619-659-5738
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist