Basic Information
Provider Information
NPI: 1023151115
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHEN
FirstName: BERTHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1804 EMBARCADERO RD
Address2: STE 100
City: PALO ALTO
State: CA
PostalCode: 943033341
CountryCode: US
TelephoneNumber: 6507234000
FaxNumber:  
Practice Location
Address1: 300 PASTEUR DR
Address2:  
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6504985391
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/15/2007
LastUpdateDate: 09/20/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VG0400XG76784CAN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
207VF0040XG76784CAY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery

No ID Information.


Home