Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC33293 | CA |
N | 111NR0200X | Radiology | RHC00202341 | CA |
N | 213ER0200X | Radiology | RHC00202341 | CA |
NPI | 1902330434 |
---|---|
Provider Name | Dr. David Chen |
First Address | South Pasadena, CA 91030-5721 |
Second Address | South Pasadena, CA 91030-5721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2017 |
Last Update Date | 11/04/2017 |