Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A147355 | CA |
NPI | 1104210152 |
---|---|
Provider Name | James Benjamin Chen |
First Address | Laguna Woods, CA 92637-3116 |
Second Address | Laguna Woods, CA 92637-3116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 06/07/2021 |