Provider Demographics
NPI:1568447621
Name:CHEN, PATRICIA MEN-CHUNG (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MEN-CHUNG
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7551 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7449
Mailing Address - Country:US
Mailing Address - Phone:916-904-3000
Mailing Address - Fax:
Practice Address - Street 1:7551 MADISON AVE
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7449
Practice Address - Country:US
Practice Address - Phone:916-904-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76443207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A764430Medicare PIN
CAF77238Medicare UPIN