Provider Demographics
NPI:1649203332
Name:CHEN, CAROLYN SZE-YUN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:SZE-YUN
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:SZE-YUN
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:101 MISSION ST STE 800
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-1744
Mailing Address - Country:US
Mailing Address - Phone:415-231-5333
Mailing Address - Fax:415-231-5332
Practice Address - Street 1:101 MISSION ST STE 800
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-1744
Practice Address - Country:US
Practice Address - Phone:415-231-5333
Practice Address - Fax:415-231-5332
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0042843207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO38008238Medicaid
CO38008238Medicaid
C806392Medicare PIN
COI62984Medicare UPIN