Provider Demographics
NPI:1902390990
Name:CHEN, JESSE LIANGYU (DO)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:LIANGYU
Last Name:CHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 LINDERO CANYON RD # 343
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-5457
Mailing Address - Country:US
Mailing Address - Phone:818-879-3511
Mailing Address - Fax:
Practice Address - Street 1:23801 NEWHALL AVE
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-3126
Practice Address - Country:US
Practice Address - Phone:818-879-3511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A19054207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine