Provider Demographics
NPI:1740483601
Name:EDWARD CHEN PERINATOLOGY CORP
Entity type:Organization
Organization Name:EDWARD CHEN PERINATOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-288-4218
Mailing Address - Street 1:500 N GARFIELD AVE
Mailing Address - Street 2:206
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1242
Mailing Address - Country:US
Mailing Address - Phone:626-288-4218
Mailing Address - Fax:626-288-4178
Practice Address - Street 1:500 N GARFIELD AVE
Practice Address - Street 2:206
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1242
Practice Address - Country:US
Practice Address - Phone:626-288-4218
Practice Address - Fax:626-288-4178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50499207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1164463345OtherINDIVIDUAL NPI NUMBER
CA00C504990Medicaid
CA00C504990Medicaid
CAC50449AMedicare ID - Type Unspecified