Fangyun Lu Chen
Individual provider Active NPI Pharmacist · South Gate, CA
NPI 1295055358 · NPPES record last updated Jun 10, 2010
Key facts
- NPI
- 1295055358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 38580 (CA)
- Practice address
- 9715 Otis St
South Gate, CA 90280-4931 - Phone
- (323) 566-1198
- NPI assigned
- Jun 10, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38580 | CA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 38580 | CA | Yes |
Addresses
Primary practice location
9715 Otis St
South Gate, CA 90280-4931
Mailing address
9715 Otis St
South Gate, CA 90280-4931
Other providers in South Gate, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.