Provider Demographics
NPI:1851476832
Name:CHRISTOPHER CHEN, M.D., INC.
Entity Type:Organization
Organization Name:CHRISTOPHER CHEN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-461-2840
Mailing Address - Street 1:4439 STONERIDGE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8339
Mailing Address - Country:US
Mailing Address - Phone:925-461-2840
Mailing Address - Fax:800-940-9545
Practice Address - Street 1:4439 STONERIDGE DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8339
Practice Address - Country:US
Practice Address - Phone:925-461-2840
Practice Address - Fax:925-461-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG063956174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA006639560Medicare PIN
CA00G639560Medicare ID - Type UnspecifiedDR. CHEN'S INDIVIDUAL NUM