Provider Demographics
NPI:1891870317
Name:CHEN, THOMAS TAI HON (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:TAI HON
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 1:2589 SAMARITAN DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4102
Mailing Address - Country:US
Mailing Address - Phone:408-426-4900
Mailing Address - Fax:
Practice Address - Street 1:2589 SAMARITAN DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4102
Practice Address - Country:US
Practice Address - Phone:408-426-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84369207RX0202X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G843690Medicaid
CA00G843690Medicaid
CAG79349Medicare UPIN