MEDICARE: BAO QIN CHEN C. A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC0087330	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093890592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAO QIN CHEN C. A.

Provider Business Mailing Address
First Line	:	212 S ATLANTIC BLVD
Second Line	:	206
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1754
Country	:	US
Telephone Number	:	323-721-5198
Fax Number	:	323-721-5171

Provider Business Practice Location Address
First Line	:	212 S ATLANTIC BLVD
Second Line	:	206
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1754
Country	:	US
Telephone Number	:	323-721-5198
Fax Number	:	323-721-5171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/09/2007

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Directions to “ BAO QIN CHEN C. A.” Practice Location

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