Provider Demographics
NPI:1104403914
Name:CHEN, TRAVIS JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:JUSTIN
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1111 E SPRUCE AVE STE 431
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3330
Mailing Address - Country:US
Mailing Address - Phone:559-450-5611
Mailing Address - Fax:559-450-7470
Practice Address - Street 1:1221 E SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3374
Practice Address - Country:US
Practice Address - Phone:559-450-5777
Practice Address - Fax:556-450-5687
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2024-08-12
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Provider Licenses
StateLicense IDTaxonomies
CAA196727207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine