Healthcare Provider Details

I. General information

NPI: 1902159171
Provider Name (Legal Business Name): TEACHER CHEN'S HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S MURPHY AVE
SUNNYVALE CA
94086-6116
US

IV. Provider business mailing address

53 CRONIN DR
SANTA CLARA CA
95051-6719
US

V. Phone/Fax

Practice location:
  • Phone: 408-984-2455
  • Fax: 408-984-2456
Mailing address:
  • Phone: 408-984-2455
  • Fax: 408-984-2456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC27826
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC15022
License Number StateCA

VIII. Authorized Official

Name: DR. CHARLES D FRACH
Title or Position: OFFICE MANAGER
Credential: PHD
Phone: 408-984-2455