Provider Demographics
NPI:1689270357
Name:CHEN, MATTHEW S (DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:S
Last Name:CHEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1141
Mailing Address - Country:US
Mailing Address - Phone:408-248-6886
Mailing Address - Fax:408-248-4923
Practice Address - Street 1:1633 BAYSHORE HWY STE 145
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1530
Practice Address - Country:US
Practice Address - Phone:650-239-9075
Practice Address - Fax:650-689-5226
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT298920225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist