Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A75341 | CA |
NPI | 1396734505 |
---|---|
Provider Name | Christopher J Chen |
First Address | Berkeley, CA 94705-2058 |
Second Address | Berkeley, CA 94705-2058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H42471 | (02) | CA |