Provider Demographics
NPI:1265810337
Name:CHEN, ALICE I-CHI (DO)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:I-CHI
Last Name:CHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9500 GILMAN DR # MC0980
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0980
Mailing Address - Country:US
Mailing Address - Phone:844-747-0474
Mailing Address - Fax:858-334-4641
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:844-747-0474
Practice Address - Fax:858-334-4641
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A16077204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM