Provider Demographics
NPI:1447512439
Name:CHEN, LOUIS
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 GARVEY AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2473
Mailing Address - Country:US
Mailing Address - Phone:626-288-8010
Mailing Address - Fax:626-288-8505
Practice Address - Street 1:8150 GARVEY AVE STE 107
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2473
Practice Address - Country:US
Practice Address - Phone:626-288-8010
Practice Address - Fax:626-288-8505
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY42884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1162660001Medicare NSC