Basic Information
Provider Information
NPI: 1760804157
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHEN
FirstName: RENEE
MiddleName: TRAN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1720 E CESAR E CHAVEZ AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900332414
CountryCode: US
TelephoneNumber: 3232685000
FaxNumber:  
Practice Location
Address1: 1720 E CESAR E CHAVEZ AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900332414
CountryCode: US
TelephoneNumber: 3232685000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/20/2014
LastUpdateDate: 12/12/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XA127509CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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