Healthcare Provider Details

I. General information

NPI: 1487100277
Provider Name (Legal Business Name): CHUN JEN HUANG L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 LAKEVIEW DR APT 307
BETHESDA MD
20817-6452
US

IV. Provider business mailing address

7420 LAKEVIEW DR APT 307
BETHESDA MD
20817-6452
US

V. Phone/Fax

Practice location:
  • Phone: 240-645-7137
  • Fax:
Mailing address:
  • Phone: 240-645-7137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU02115
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: