Provider Demographics
NPI:1912989724
Name:CHEN, DARYL M (MD)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:M
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25825 VERMONT AVE
Mailing Address - Street 2:KAISER SOUTH BAY MEDICAL CENTER, DIAGNOSTIC IMAGING
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-3518
Mailing Address - Country:US
Mailing Address - Phone:310-257-5859
Mailing Address - Fax:310-257-6193
Practice Address - Street 1:25825 VERMONT AVE
Practice Address - Street 2:KAISER SOUTH BAY MEDICAL CENTER, DIAGNOSTIC IMAGING
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3518
Practice Address - Country:US
Practice Address - Phone:310-257-5859
Practice Address - Fax:310-257-6193
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2021-11-29
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Provider Licenses
StateLicense IDTaxonomies
CAA803072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H77136Medicare UPIN