PO Zan Chen Medical Corporation

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

A24530 Issued in CA

Legal business name

PO ZAN CHEN MEDICAL CORPORATION

Practice address

2605 1/2 W Beverly Blvd
Montebello, CA 90640-2309

Phone

(323) 722-5700

Fax

(323) 722-5701

NPI assigned

Aug 26, 2005

Reactivated

Sep 29, 2005

Organization subpart

No

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

Authorized official

Name

PO Zan Chen, M.D.

Title

President

Phone

(323) 722-5700

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942293659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 1/2 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402309",
            "telephone_number": "323-722-5700",
            "fax_number": "323-722-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 1/2 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402309",
            "telephone_number": "323-722-5700",
            "fax_number": "323-722-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PO ZAN CHEN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2020-08-22",
        "deactivation_date": "2005-08-26",
        "reactivation_date": "2005-09-29",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "PO",
        "authorized_official_middle_name": "ZAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-722-5700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "A24530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A245300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Montebello, CA
• Providers in Montebello, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.