Mary Chen MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A78207 Issued in CA

Legal business name

MARY CHEN MD INC

Practice address

18780 Amar Rd
Suite 107
Walnut, CA 91789-4560

Phone

(626) 810-6777

Fax

(626) 810-6687

NPI assigned

Jan 10, 2007

Last updated

Apr 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Chen, MDNPI 1568445229

Title

President

Phone

(626) 810-6777

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Chen, M.D.

  • Internal Medicine Physician
  • Walnut, CA
  • NPI 1568445229
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1366591174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18780 AMAR RD",
            "address_2": "SUITE 107",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917894560",
            "telephone_number": "626-810-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18780 AMAR RD",
            "address_2": "SUITE 107",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917894560",
            "telephone_number": "626-810-6777",
            "fax_number": "626-810-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY CHEN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-810-6777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A782070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Walnut, CA
• Providers in Walnut, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.