Provider Demographics
NPI:1336750918
Name:CHEN, CHRISTOPHER QI-SHENG (PHARMACIST INTERN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:QI-SHENG
Last Name:CHEN
Suffix:
Gender:M
Credentials:PHARMACIST INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 N STONEMAN AVE APT D
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1428
Mailing Address - Country:US
Mailing Address - Phone:626-701-7965
Mailing Address - Fax:
Practice Address - Street 1:3408 N EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-1934
Practice Address - Country:US
Practice Address - Phone:323-222-2362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46568390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA46568OtherCALIFORNIA STATE BOARD OF PHARMACY