Provider Demographics
NPI:1649471103
Name:ALBERT C CHEN M D MEDICAL CORPORATION
Entity type:Organization
Organization Name:ALBERT C CHEN M D MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANTOANETA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-325-1198
Mailing Address - Street 1:3655 LOMITA BLVD STE 321
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-1927
Mailing Address - Country:US
Mailing Address - Phone:310-325-1198
Mailing Address - Fax:
Practice Address - Street 1:3655 LOMITA BLVD STE 321
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-1927
Practice Address - Country:US
Practice Address - Phone:310-325-1198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G557511Medicaid
CA00G557511Medicaid
CAE51985Medicare UPIN