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General NPI Number Information
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NPI Number | 1548632664
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Entity Type | Organization
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Legal Business Name | P. CHEN CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 15840 VENTURA BLVD STE 106
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City | ENCINO
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State | CA
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Zip | 91436-4739
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Country | US
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Telephone | 626-287-5088
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2453
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City | SAN GABRIEL
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State | CA
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Zip | 91778-2453
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Country | US
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Telephone | 626-287-5088
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL CHEN
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Credential | D.C.
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Telephone | 626-287-5088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 29612
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License Number State | CA
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