Individual
JACLYN J CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 30TH ST STE 100, OAKLAND, CA 94609
(510) 204-8168
(510) 506-7725
Mailing address
2350 W EL CAMINO REAL FL 2, MOUNTAIN VIEW, CA 94040-6203
(510) 204-8168
(510) 506-7725
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A120533
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A120533
STATE MEDICAL LICENSE
CA
Enumeration date
06/04/2010
Last updated
06/03/2022
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