Provider Demographics
NPI:1952631632
Name:CHEN, BRIAN HONG (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:HONG
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S SANTA ANITA ST STE P25
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1145
Mailing Address - Country:US
Mailing Address - Phone:626-284-8448
Mailing Address - Fax:
Practice Address - Street 1:207 S SANTA ANITA ST STE P25
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1145
Practice Address - Country:US
Practice Address - Phone:626-284-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-02
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195228207R00000X, 207W00000X
FLTRN19262207W00000X
CAA127719207WX0009X
CA127719207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist