Healthcare Provider Details

I. General information

NPI: 1750688495
Provider Name (Legal Business Name): WENDY CHEN, CHIROPRACTIC, A PROFESSIONAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 S EUCLID AVE
PASADENA CA
91101-2717
US

IV. Provider business mailing address

412 E LA SIERRA DR
ARCADIA CA
91006-4351
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-1201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC30899
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11933
License Number StateCA

VIII. Authorized Official

Name: WENDY CHEN
Title or Position: D.C., L.AC
Credential:
Phone: 626-215-2958