Provider Demographics
NPI:1891738472
Name:CHEN, CHRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
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 DR
Practice Address - Street 2:STE 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:800-940-9545
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG063956173000000X, 207LA0401X, 207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No173000000XOther Service ProvidersLegal Medicine
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G639560Medicare ID - Type UnspecifiedMEDICARE ID