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General NPI Number Information
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NPI Number | 1639662471
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Entity Type | Organization
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Legal Business Name | CALIFORNIA CARE MEDICAL GROUP LLC
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 2063 S ATLANTIC BLVD STE B
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City | MONTEREY PARK
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State | CA
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Zip | 91754-6345
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Country | US
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Telephone | 323-981-9981
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Fax |
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Provider Business Mailing Address
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Address Line | 2063 S ATLANTIC BLVD STE B
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City | MONTEREY PARK
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State | CA
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Zip | 91754-6345
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | JING CHEN
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Credential | LAC, ACUPUNCTURIST
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Telephone | 323-981-9981
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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 | AC3761
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License Number State | CA
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