Provider Demographics
NPI:1912220138
Name:CHEN, ELI (MD)
Entity Type:Individual
Prefix:
First Name:ELI
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18550 DE PAUL DR STE 203
Mailing Address - Street 2:
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:408-659-8388
Practice Address - Street 1:18550 DE PAUL DR STE 203
Practice Address - Street 2:
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:408-659-8388
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA116911207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery