MEDICARE: DR. ZHAO CHEN O.M.D.

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	LAC9521	CA

General Provider Information

NPI Number	:	1538212824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZHAO CHEN O.M.D.

Provider Business Mailing Address
First Line	:	1005 A ST
Second Line	:	SUITE 210
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-3123
Country	:	US
Telephone Number	:	415-455-9295
Fax Number	:	650-583-3656

Provider Business Practice Location Address
First Line	:	1005 A ST
Second Line	:	SUITE 210
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-3123
Country	:	US
Telephone Number	:	415-455-9295
Fax Number	:	650-583-3656

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

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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