Provider Demographics
NPI:1114002607
Name:CHEN, WEISEN (PHARM D)
Entity type:Individual
Prefix:
First Name:WEISEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 HOMEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-5054
Mailing Address - Country:US
Mailing Address - Phone:916-973-5655
Mailing Address - Fax:
Practice Address - Street 1:2206 HOMEWOOD WAY
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-5054
Practice Address - Country:US
Practice Address - Phone:916-973-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist