Healthcare Provider Details

I. General information

NPI: 1073654653
Provider Name (Legal Business Name): CHEN CHIROPRACTIC INTEGRATIVE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10053 VALLEY BLVD STE 7
EL MONTE CA
91731-1764
US

IV. Provider business mailing address

10053 VALLEY BLVD STE 7
EL MONTE CA
91731-1764
US

V. Phone/Fax

Practice location:
  • Phone: 626-444-5130
  • Fax: 626-444-5131
Mailing address:
  • Phone: 626-444-5130
  • Fax: 626-444-5131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29121
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC10172
License Number StateCA

VIII. Authorized Official

Name: DR. JASON HSIN CHEN
Title or Position: OWNER
Credential: DC, L.AC.
Phone: 626-444-5130