Provider Demographics
NPI:1427250588
Name:CHEN, JAMES YEN-YU (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:YEN-YU
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103
Practice Address - Country:US
Practice Address - Phone:619-543-2218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1086352085N0700X
PAMD4312702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-1955165OtherAETNA
PA23-1955165OtherINTERGROUP SERVICES
PA30043061OtherKEYSTONE MERCY
PA38133MD431270OtherHEALTH PARTNERS
PAP00401161OtherRAILROAD MEDICARE
PA1969269OtherPA BLUE SHIELD
PA9475020OtherPHCS
PA101930777-0001Medicaid
PA20067678OtherAMERIHEALTH MERCY
PA2850090000OtherIBC / KHPE
PA23-1955165OtherAETNA