Provider Demographics
NPI:1770231540
Name:MANG CHEN MD PC
Entity Type:Organization
Organization Name:MANG CHEN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-481-3890
Mailing Address - Street 1:45 CASTRO ST STE 111
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1019
Mailing Address - Country:US
Mailing Address - Phone:415-481-3890
Mailing Address - Fax:520-585-6303
Practice Address - Street 1:45 CASTRO ST STE 111
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1019
Practice Address - Country:US
Practice Address - Phone:415-481-3890
Practice Address - Fax:520-585-6303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty