Provider Demographics
NPI:1609013440
Name:CHEN, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 S SAN GABRIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2743
Mailing Address - Country:US
Mailing Address - Phone:626-286-8700
Mailing Address - Fax:626-286-8650
Practice Address - Street 1:923 S SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2743
Practice Address - Country:US
Practice Address - Phone:626-286-8700
Practice Address - Fax:626-286-8650
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39123174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC39123OtherSTATE LICENSE NUMBER
CAC39123OtherSTATE LICENSE NUMBER