Provider Demographics
NPI:1790861540
Name:CHEN, BIHONG TANG (MD)
Entity Type:Individual
Prefix:
First Name:BIHONG
Middle Name:TANG
Last Name:CHEN
Suffix:
Gender:F
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:PO BOX 512185
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0185
Mailing Address - Country:US
Mailing Address - Phone:626-775-3514
Mailing Address - Fax:626-218-5310
Practice Address - Street 1:1500 E. DUARTE RD.
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-3200
Practice Address - Country:US
Practice Address - Phone:626-359-8111
Practice Address - Fax:626-775-3271
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000443422085R0202X
CAA661112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
335760OtherINTERNAL ID-MOTOR VEHICLE ID
CAA7209578OtherCA DRIVER'S LICENSE
WA84284889Medicaid
CAA7209578OtherCA DRIVER'S LICENSE
H69976Medicare UPIN