Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | A129934 | CA |
NPI | 1164786521 |
---|---|
Provider Name | Dr. Samuel Lo Chen |
First Address | Orange, CA 92868-5903 |
Second Address | Orange, CA 92868-2950 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2012 |
Last Update Date | 14/09/2020 |