Provider Demographics
NPI:1831197284
Name:CHEN, VINCENT W (MD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:W
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:4760 W SUNSET BLVD
Mailing Address - Street 2:DEPT. OF ORTHOPAEDICS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6063
Mailing Address - Country:US
Mailing Address - Phone:323-783-6806
Mailing Address - Fax:323-783-8948
Practice Address - Street 1:4760 W SUNSET BLVD
Practice Address - Street 2:DEPT. OF ORTHOPAEDICS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6063
Practice Address - Country:US
Practice Address - Phone:323-783-6806
Practice Address - Fax:323-783-8948
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA86426207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH83893Medicare UPIN
CAWA86426Medicare ID - Type Unspecified