Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | G64782 | CA |
NPI | 1174543334 |
---|---|
Provider Name | Ming Teh Dwight Chen |
First Address | Los Altos, CA 94022-1408 |
Second Address | Mountain View, CA 94040-4124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 23/01/2020 |