Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | A30781 | CA |
NPI | 1235114950 |
---|---|
Provider Name | Dr. Carl C Chen |
First Address | Fullerton, CA 92835-1041 |
Second Address | Fullerton, CA 92835-3827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 18/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A307810 | (05) | CA |
A26234 | (02) | CA |