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General NPI Number Information
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NPI Number | 1548698707
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Entity Type | Individual
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Provider Name | STANLY CHUONG L.AC
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Gender | Male
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Dates
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Enumeration Date | 10/28/2013
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 2020 COFFEE RD., STE. B5
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-464-2095
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Fax | 209-491-2000
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Provider Business Mailing Address
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Address Line | 2020 COFFEE RD., STE. B5
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-464-4192
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Fax | 209-464-0288
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AC10857
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License Number State | CA
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