Provider Demographics
NPI:1962968032
Name:CHEN, ELAINE L (PA-C)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:L
Last Name:CHEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:12155 RAMONA BLVD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-2495
Mailing Address - Country:US
Mailing Address - Phone:626-231-6431
Mailing Address - Fax:
Practice Address - Street 1:630 S RAYMOND AVE UNIT 310
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3206
Practice Address - Country:US
Practice Address - Phone:626-598-3770
Practice Address - Fax:626-598-3797
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA56541363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical