Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 01062646A | IN |
N | 2084N0402X | Child Neurologist | A45777 | CA |
NPI | 1265520837 |
---|---|
Provider Name | Lan Shu Chen |
First Address | Indianapolis, IN 46202-5112 |
Second Address | Indianapolis, IN 46202-5112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 21/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A457770 | (05) | CA |
00A457770 L59 | CAL OPTIMA (01) | CA |
200866370 | (05) | IN |
F35480 | (02) | CA |