Provider Demographics
NPI:1700019528
Name:CHEN, HAMILTON (MD)
Entity Type:Individual
Prefix:DR
First Name:HAMILTON
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 1:6900 BROCKTON AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3817
Mailing Address - Country:US
Mailing Address - Phone:951-784-7111
Mailing Address - Fax:951-823-0378
Practice Address - Street 1:6900 BROCKTON AVE
Practice Address - Street 2:STE 103
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3817
Practice Address - Country:US
Practice Address - Phone:951-784-7111
Practice Address - Fax:951-823-0378
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1137442081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine