MEDICARE: JOHNNY CHEN LAC., DIPL. O.M., PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC16856	CA

General Provider Information

NPI Number	:	1225984735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNNY CHEN LAC., DIPL. O.M., PH

Provider Business Mailing Address
First Line	:	2707 E VALLEY BLVD STE 101
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3196
Country	:	US
Telephone Number	:	626-964-6588
Fax Number	:

Provider Business Practice Location Address
First Line	:	2707 E VALLEY BLVD STE 101
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3196
Country	:	US
Telephone Number	:	626-964-6588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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