Healthcare Provider Details

I. General information

NPI: 1477484996
Provider Name (Legal Business Name): MODERN CM HEALTHCARE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4325 MOORPARK AVE STE B
SAN JOSE CA
95129-2076
US

IV. Provider business mailing address

4325 MOORPARK AVE STE B
SAN JOSE CA
95129-2076
US

V. Phone/Fax

Practice location:
  • Phone: 408-390-8377
  • Fax:
Mailing address:
  • Phone: 408-390-8377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. YI-CHUNG CHAO
Title or Position: CEO
Credential: L.AC
Phone: 408-390-8377