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General NPI Number Information
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NPI Number | 1962662288
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Entity Type | Individual
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Provider Name | JENG KUAN L.AC., D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 09/20/2010
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Provider Practice Location Address
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Address Line | 11 EDGEWOOD RD
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City | MATAWAN
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State | NJ
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Zip | 07747-3726
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Country | US
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Telephone | 626-862-7788
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Fax |
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Provider Business Mailing Address
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Address Line | 11 EDGEWOOD RD
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City | MATAWAN
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State | NJ
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Zip | 07747-3726
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Country | US
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Telephone | 626-862-7788
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC10988
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00066200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00676900
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License Number State | NJ
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