Provider Demographics
NPI:1457375297
Name:CHEN, HUA (MD)
Entity Type:Individual
Prefix:DR
First Name:HUA
Middle Name:
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 1:373 9TH ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-6514
Mailing Address - Country:US
Mailing Address - Phone:510-251-0688
Mailing Address - Fax:510-251-1055
Practice Address - Street 1:373 9TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-6514
Practice Address - Country:US
Practice Address - Phone:510-251-0688
Practice Address - Fax:510-251-1055
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA00553310Medicaid
CAA00553310Medicare ID - Type UnspecifiedMADICARE
CAA00553310Medicaid