Individual provider · NPI-1

Ethan Wesley Chen, MD

Radiology, Diagnostic Radiology · Loma Linda, CA

NPI number1952042855
StatusActive
Last updated in NPPESJan 6, 2025

Details

NPI
1952042855
Entity type
Individual (NPI-1)
Name
Ethan Wesley Chen
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 5, 2022
Certification date
Jan 6, 2025
Last updated
Jan 6, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085R0202X Radiology, Diagnostic RadiologyC187759CAYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

24887 Taylor St # 202
Loma Linda, CA 92350-0225

Phone 909-558-6131

Mailing address

1000 W Carson St # 400
Torrance, CA 90502-2059

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