Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A99622 | CA |
Y | 208600000X | Surgeon | A99622 | CA |
NPI | 1003078338 |
---|---|
Provider Name | Michael W Chen |
First Address | Santa Monica, CA 90404-2050 |
Second Address | Santa Monica, CA 90404-2050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2008 |
Last Update Date | 14/12/2021 |