Provider Demographics
NPI:1609301100
Name:CHEN, TRACY XIAOZHEN (MD)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:XIAOZHEN
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 1ST AVE APT 437
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-3149
Mailing Address - Country:US
Mailing Address - Phone:208-860-6561
Mailing Address - Fax:
Practice Address - Street 1:1380 LUSITANA ST STE 1004
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2461
Practice Address - Country:US
Practice Address - Phone:808-686-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-22
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD473780207V00000X
390200000X
HIMD-22261-0207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program