Healthcare Provider Details
I. General information
NPI: 1093951980
Provider Name (Legal Business Name): BILL CHAO CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/23/2008
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9955 LOWER AZUSA RD #101
TEMPLE CITY CA
91780-4059
US
IV. Provider business mailing address
9955 LOWER AZUSA RD #101
TEMPLE CITY CA
91780-4059
US
V. Phone/Fax
- Phone: 626-688-9999
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC28043 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC12810 |
| License Number State | CA |
VIII. Authorized Official
Name:
BILL
CHAO
Title or Position: PRESIDENT
Credential: D.C.
Phone: 626-688-9999