Provider Demographics
NPI:1386697431
Name:ANTHONY J CHEN MD INC
Entity type:Organization
Organization Name:ANTHONY J CHEN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-375-1728
Mailing Address - Street 1:3640 LOMITA BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3927
Mailing Address - Country:US
Mailing Address - Phone:310-375-1728
Mailing Address - Fax:310-375-1708
Practice Address - Street 1:3640 LOMITA BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3927
Practice Address - Country:US
Practice Address - Phone:310-375-1728
Practice Address - Fax:310-375-1708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75084207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19655Medicare ID - Type Unspecified