Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A94883 | CA |
NPI | 1083792667 |
---|---|
Provider Name | Anton Chen |
First Address | Oakland, CA 94612-3466 |
Second Address | Sacramento, CA 95825-2115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 13/12/2021 |