Provider Demographics
NPI:1760656276
Name:CHA, STEPHANIE CHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:CHEN
Last Name:CHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2757
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92859-0757
Mailing Address - Country:US
Mailing Address - Phone:714-973-2650
Mailing Address - Fax:714-973-2655
Practice Address - Street 1:13222 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3249
Practice Address - Country:US
Practice Address - Phone:562-863-4763
Practice Address - Fax:562-207-9721
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2015-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA111403207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGJ191ZMedicare PIN