Provider Demographics
NPI:1942488101
Name:CHEN, ABRAHAM SHIN-UN (DO)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:SHIN-UN
Last Name:CHEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:10995 EUCALYPTUS ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7686
Mailing Address - Country:US
Mailing Address - Phone:909-466-6310
Mailing Address - Fax:909-466-6325
Practice Address - Street 1:10995 EUCALYPTUS ST
Practice Address - Street 2:SUITE 102
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7686
Practice Address - Country:US
Practice Address - Phone:909-466-6310
Practice Address - Fax:909-466-6325
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7871207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A7871OtherCALIFORNIA LICENSE
BC6626533OtherDEA
CA20A7871OtherCALIFORNIA LICENSE