Provider Demographics
NPI:1891040531
Name:ELI CHEN, M.D., INC.
Entity Type:Organization
Organization Name:ELI CHEN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-782-4060
Mailing Address - Street 1:18550 DE PAUL DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2911
Mailing Address - Country:US
Mailing Address - Phone:408-782-4060
Mailing Address - Fax:
Practice Address - Street 1:18550 DE PAUL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2911
Practice Address - Country:US
Practice Address - Phone:408-782-4060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116911207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty