Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1300X | Electrophysiology, Clinical | PT22344 | CA |
Y | 2251G0304X | Physical Therapist - Geriatrics | PT22344 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT22344 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT22344 | CA |
NPI | 1841564754 |
---|---|
Provider Name | Mr. Charles H Chen |
First Address | San Gabriel, CA 91776-2462 |
Second Address | Alhambra, CA 91801-3300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2012 |
Last Update Date | 24/02/2012 |