Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | A30902 | CA |
NPI | 1083835854 |
---|---|
Provider Name | Dr. Jei-Po Chen |
First Address | Rancho Cucamonga, CA 91730 |
Second Address | Rancho Cucamonga, CA 91730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A26275 | (02) | CA |