Healthcare Provider Details

I. General information

NPI: 1073636767
Provider Name (Legal Business Name): HSIU LING CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

992 BORANDA AVE
MOUNTAIN VIEW CA
94040-2625
US

IV. Provider business mailing address

PO BOX 390878
MOUNTAIN VIEW CA
94039-0878
US

V. Phone/Fax

Practice location:
  • Phone: 650-625-0780
  • Fax:
Mailing address:
  • Phone: 650-625-0780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC10683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: