Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | A46592 | CA |
NPI | 1134293731 |
---|---|
Provider Name | Emily Chen |
First Address | Oakland, CA 94612-3466 |
Second Address | San Jose, CA 95119-1130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A465920 | (05) | CA |
F83702 | (02) |