Provider Demographics
NPI:1215291570
Name:CHEN, TRACY SHIH-CHIEH (DO)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:SHIH-CHIEH
Last Name:CHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CROSSROADS BLVD # 200
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8674
Mailing Address - Country:US
Mailing Address - Phone:310-699-5661
Mailing Address - Fax:
Practice Address - Street 1:225 CROSSROADS BLVD # 200
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8674
Practice Address - Country:US
Practice Address - Phone:310-699-5661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010201392085R0202X
CA20A-156382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology