Provider Demographics
NPI:1285785519
Name:DAVID C P CHEN, M.D., INC
Entity type:Organization
Organization Name:DAVID C P CHEN, M.D., INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:LA ROCCA
Authorized Official - Suffix:
Authorized Official - Credentials:BILLING MANAGER
Authorized Official - Phone:626-282-2802
Mailing Address - Street 1:1129 S SAN GABRIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3114
Mailing Address - Country:US
Mailing Address - Phone:626-282-2802
Mailing Address - Fax:626-282-2202
Practice Address - Street 1:1129 S SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3114
Practice Address - Country:US
Practice Address - Phone:626-282-2802
Practice Address - Fax:626-282-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0018480Medicaid
CAGR0018483Medicaid
CAGR0018482Medicaid
CAGR0018482Medicaid
CAW8705DMedicare ID - Type UnspecifiedPROVIDER NUMBER
CAW8705EMedicare ID - Type UnspecifiedPROVIDER NUMBER
CAGR0018480Medicaid