Provider Demographics
NPI:1730239666
Name:CHEN, DEBORAH K (DPM MSME)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:K
Last Name:CHEN
Suffix:
Gender:F
Credentials:DPM MSME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CENTURY PARK E STE 1008
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2013
Mailing Address - Country:US
Mailing Address - Phone:310-553-2882
Mailing Address - Fax:310-551-0317
Practice Address - Street 1:2080 CENTURY PARK E STE 1008
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2013
Practice Address - Country:US
Practice Address - Phone:310-553-2882
Practice Address - Fax:310-551-0317
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4379213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4550280001Medicare NSC
CAE4379Medicare ID - Type Unspecified
CAU89848Medicare UPIN