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General NPI Number Information
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NPI Number | 1487066551
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Entity Type | Organization
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Legal Business Name | BALANCE CARE WELLNESS GROUP
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 05/23/2014
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Provider Practice Location Address
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Address Line | 130 W ROUTE 66 STE 312
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City | GLENDORA
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State | CA
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Zip | 91740-6252
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Country | US
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Telephone | 626-888-1394
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Fax |
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Provider Business Mailing Address
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Address Line | 733 JANICE LN
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City | WALNUT
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State | CA
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Zip | 91789-4539
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Country | US
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Telephone | 626-888-1394
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YEN CHAO CHEN
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Credential |
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Telephone | 626-888-1394
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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 | AC15269
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License Number State | CA
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