Provider Demographics
NPI:1932390325
Name:CHEN, FRED SHOONG-PING (MD)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:SHOONG-PING
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 1:6 LOCKSLEY AVE
Mailing Address - Street 2:UNIT 2K
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3854
Mailing Address - Country:US
Mailing Address - Phone:858-405-9773
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY, UCSF
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-476-8358
Practice Address - Fax:415-476-0616
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100761390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program