Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 51240 | CA |
NPI | 1023218658 |
---|---|
Provider Name | Linda Beth Chen |
First Address | Santa Monica, CA 90404-1809 |
Second Address | Santa Monica, CA 90404-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2007 |
Last Update Date | 19/05/2014 |