Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 286033 | NY |
Y | 2080P0205X | Pediatric Endocrinologist | 155889 | CA |
N | 2080P0205X | Pediatric Endocrinologist | 286033 | NY |
NPI | 1205276458 |
---|---|
Provider Name | Jarreau Chen |
First Address | Bakersfield, CA 93314 |
Second Address | Madera, CA 93636-8762 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2013 |
Last Update Date | 11/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1205276458 | (05) | CA |