Provider Demographics
NPI:1457385759
Name:CHEN, STEVE CHING-TSUNG (MD)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:CHING-TSUNG
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 1:9360 TOWNE CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3057
Mailing Address - Country:US
Mailing Address - Phone:858-232-3582
Mailing Address - Fax:
Practice Address - Street 1:9360 TOWNE CENTRE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3057
Practice Address - Country:US
Practice Address - Phone:858-232-3582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82142207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA82142AMedicare ID - Type UnspecifiedPPIN #
CAI22179Medicare UPIN