Individual
VIDA CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 E BRIGGSMORE AVE FL 2, MODESTO, CA 95355-2707
(209) 572-2736
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A171345
CA
390200000X
Student in an Organized Health Care Education/Training Program
390200000X3
—
Other
Enumeration date
06/29/2015
Last updated
07/06/2021
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