Healthcare Provider Details

I. General information

NPI: 1326166026
Provider Name (Legal Business Name): CHENSHAY KUO L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S BEACH BLVD STE B
LA HABRA CA
90631-5104
US

IV. Provider business mailing address

345 WEST RD
LA HABRA HEIGHTS CA
90631-8082
US

V. Phone/Fax

Practice location:
  • Phone: 562-694-6200
  • Fax:
Mailing address:
  • Phone: 562-690-8669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC5918
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: