MEDICARE: CHI DI CHEN L. AC

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	AC12939	CA

General Provider Information

NPI Number	:	1689984601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHI DI CHEN L. AC

Provider Business Mailing Address
First Line	:	3283 HOSTETTER RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95132-1919
Country	:	US
Telephone Number	:	408-929-5541
Fax Number	:

Provider Business Practice Location Address
First Line	:	3283 HOSTETTER RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95132-1919
Country	:	US
Telephone Number	:	408-929-5541
Fax Number	:

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

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	10/08/2010

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Directions to “ CHI DI CHEN L. AC” Practice Location

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