Provider Demographics
NPI:1912014739
Name:CHEN, ANDREW PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:PHILIP
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:521 S HAM LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-3528
Mailing Address - Country:US
Mailing Address - Phone:209-334-5886
Mailing Address - Fax:209-334-5281
Practice Address - Street 1:521 S HAM LN
Practice Address - Street 2:SUITE A
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-3528
Practice Address - Country:US
Practice Address - Phone:209-334-5886
Practice Address - Fax:209-334-5281
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-07-14
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Provider Licenses
StateLicense IDTaxonomies
CAG72858207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G728580Medicaid
CA00G728580Medicare PIN
CA00G728580Medicaid