Individual provider Active NPI

Kevin Chen, M.D.

  • Internal Medicine Physician
  • East Los Angeles, CA
National Provider Identifier
1356787576
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A132824 Issued in CA
Practice address
245 S Fetterly Ave
East Los Angeles, CA 90022-1605
Phone
(323) 362-1010
Fax
(323) 362-1379
NPI assigned
May 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A132824 CA
Internal Medicine Physician 207R00000X A132824 CA Primary

Addresses

Primary practice location

245 S Fetterly Ave
East Los Angeles, CA 90022-1605

Mailing address

245 S Fetterly Ave
East Los Angeles, CA 90022-1605
Phone (323) 362-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211220002615 CA Practitioner - Internal Medicine 3870873839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A132824CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Dec 1, 2021 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles CurrentSince Dec 1, 2021 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

245 S Fetterly Ave
Los Angeles, CA 90022
Phone (323) 362-1010

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1356787576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "city": "EAST LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "323-362-1400",
            "fax_number": "323-362-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "city": "EAST LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "323-362-1010",
            "fax_number": "323-362-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A132824",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A132824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.