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General NPI Number Information
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NPI Number | 1255646741
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Entity Type | Organization
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Legal Business Name | CHEN'S HOLISTIC ACUPUNCTURE & HERBS CLINIC, INC.
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 491 N CENTRAL AVE STE A
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City | UPLAND
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State | CA
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Zip | 91786-7278
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Country | US
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Telephone | 909-946-8306
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Fax | 909-946-1336
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Provider Business Mailing Address
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Address Line | 491 N CENTRAL AVE STE A
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City | UPLAND
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State | CA
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Zip | 91786-7278
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Country | US
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Telephone | 909-946-8306
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Fax | 909-946-1336
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Authorized Official
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Title or Position | PRESIDENT/ACUPUNCTURIST
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Name | DR. RAY R CHEN
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Credential | O.M.D., L.AC.
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Telephone | 909-946-8306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC6429
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC1475
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License Number State | CA
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