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Individual

CHUNG QUAN CHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
890 W STETSON AVE, SUITE B, HEMET, CA 92543-7311
(951) 537-6002
Mailing address
890 W STETSON AVE, SUITE B, HEMET, CA 92543-7311
(951) 537-6002

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A32875
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A328750
CA
01
00A328752
MEDICARE PTAN
CA
01
00A328753
MEDICARE PTAN
CA
01
300049524
RAILROAD MEDICARE
CA
01
300049623
RAILROAD MEDICARE
CA
Enumeration date
06/15/2006
Last updated
02/27/2013
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