Healthcare Provider Details

I. General information

NPI: 1871735332
Provider Name (Legal Business Name): BEN CHUE HER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 03/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 W BEECHWOOD AVE
PINEDALE CA
93650-1347
US

IV. Provider business mailing address

339 W BEECHWOOD AVE
PINEDALE CA
93650-1347
US

V. Phone/Fax

Practice location:
  • Phone: 209-777-3391
  • Fax:
Mailing address:
  • Phone: 209-777-3391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: