Healthcare Provider Details

I. General information

NPI: 1346957206
Provider Name (Legal Business Name): FURONG CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2022
Last Update Date: 10/31/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 N BROADWAY
WALNUT CREEK CA
94596-4222
US

IV. Provider business mailing address

4005 SARASTA BAY DR
PITTSBURG CA
94565-7928
US

V. Phone/Fax

Practice location:
  • Phone: 925-930-5639
  • Fax:
Mailing address:
  • Phone: 415-629-4194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number19518
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: