Provider Demographics
NPI:1952638462
Name:LULU L. CHEN, MD INC
Entity Type:Organization
Organization Name:LULU L. CHEN, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LULU
Authorized Official - Middle Name:LIANG-YU
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-901-4714
Mailing Address - Street 1:711 W COLLEGE ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1163
Mailing Address - Country:US
Mailing Address - Phone:213-620-9335
Mailing Address - Fax:213-620-9358
Practice Address - Street 1:711 W COLLEGE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1163
Practice Address - Country:US
Practice Address - Phone:213-620-9335
Practice Address - Fax:213-620-9358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70027207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty