Provider Demographics
NPI:1972581643
Name:CHEN, LOREN YUI (MD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:YUI
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 1:14860 ROSCOE BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4665
Mailing Address - Country:US
Mailing Address - Phone:818-787-4084
Mailing Address - Fax:818-994-4491
Practice Address - Street 1:14860 ROSCOE BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4665
Practice Address - Country:US
Practice Address - Phone:818-787-4084
Practice Address - Fax:818-994-4491
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60889207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9990935Medicaid
CA9990935Medicaid
CAW17920Medicare ID - Type Unspecified