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General NPI Number Information
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NPI Number | 1760856397
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Entity Type | Individual
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Provider Name | HENRY CHHUON
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Gender | Male
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 2500 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90057-4303
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Country | US
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Telephone | 213-639-2660
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Fax |
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Provider Business Mailing Address
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Address Line | 9519 DARNELL ST
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City | BELLFLOWER
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State | CA
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Zip | 90706-3507
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Country | US
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Telephone | 562-728-7936
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Fax |
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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 | 167G00000X
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Taxonomy Name | Licensed Psychiatric Technician
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License Number | PT 38304
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License Number State | CA
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