Provider Demographics
NPI:1760486419
Name:CHEN, PAUL HONG-DZE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HONG-DZE
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1905 CALLE BARCELONA
Mailing Address - Street 2:STE 208
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8452
Mailing Address - Country:US
Mailing Address - Phone:760-930-9696
Mailing Address - Fax:760-930-0737
Practice Address - Street 1:1905 CALLE BARCELONA
Practice Address - Street 2:STE 208
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8452
Practice Address - Country:US
Practice Address - Phone:760-930-9696
Practice Address - Fax:760-930-9696
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA65156207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9170433Medicaid
CAH15914Medicare UPIN
CAA65156Medicare ID - Type Unspecified
CA9170433Medicaid