Provider Demographics
NPI:1942396197
Name:CHEN, MELINDA A (MD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:A
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8939 VILLA LA JOLLA DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1732
Mailing Address - Country:US
Mailing Address - Phone:858-657-8000
Mailing Address - Fax:
Practice Address - Street 1:8939 VILLA LA JOLLA DR
Practice Address - Street 2:SUITE 110
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1732
Practice Address - Country:US
Practice Address - Phone:858-657-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08108700207R00000X
NY258967207R00000X
CAA91243207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine