Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | G76785 | CA |
NPI | 1013991009 |
---|---|
Provider Name | Dr. Steve Chen |
First Address | Beverly Hills, CA 90211-2007 |
Second Address | Beverly Hills, CA 90211-2007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G767850 | (05) | CA |
H22753 | (02) | CA |