Provider Demographics
NPI:1629259726
Name:CHEN, ROSANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ROSANNA
Other - Middle Name:POK YEUNG
Other - Last Name:FONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:326 WESTLAKE CTR
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1431
Mailing Address - Country:US
Mailing Address - Phone:650-992-2020
Mailing Address - Fax:650-992-1105
Practice Address - Street 1:326 WESTLAKE CTR
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1431
Practice Address - Country:US
Practice Address - Phone:650-992-2020
Practice Address - Fax:650-992-1105
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13448152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist