Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | A31021 | CA |
NPI | 1316276942 |
---|---|
Provider Name | Ming-Kong Chen |
First Address | Northridge, CA 91326-2235 |
Second Address | Valencia, CA 91355-5319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2009 |
Last Update Date | 10/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A310210 | (05) | CA |
C01234 | (02) | CA |