1679827679 NPI number — PHIL Y. C. CHEN, D.O., A PROFESSIONAL CORPORATION

Table of content: (NPI 1679827679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679827679 NPI number — PHIL Y. C. CHEN, D.O., A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHIL Y. C. CHEN, D.O., A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADVANCED PAIN MANAGEMENT AND FAMILY CARE ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679827679
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
219 N PECOS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89074-7359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-260-7818
Provider Business Mailing Address Fax Number:
702-260-7238

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
219 N PECOS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89074-7359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-260-7818
Provider Business Practice Location Address Fax Number:
702-260-7238
Provider Enumeration Date:
10/30/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CHEN
Authorized Official First Name:
PHIL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
702-260-7818

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  871 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2300X , with the licence number: 20A7220 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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