Provider Demographics
NPI:1720180946
Name:CHEN, TERENCE LING (MD)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:LING
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1101 SE TECH CENTER DRIVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5521
Mailing Address - Country:US
Mailing Address - Phone:360-514-9040
Mailing Address - Fax:360-514-9041
Practice Address - Street 1:1455 MONTEGO STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-937-0404
Practice Address - Fax:925-937-1340
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG71608207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G716080OtherBLUE SHIELD OF CA
G71608OtherBLUE CROSS OF CA
CA00G716080Medicare ID - Type Unspecified
00G716080OtherBLUE SHIELD OF CA