Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 3802 | CA |
NPI | 1528689809 |
---|---|
Provider Name | Guanghuo Chen |
First Address | Baldwin Park, CA 91706-5455 |
Second Address | Anaheim, CA 92807-2716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2020 |
Last Update Date | 28/04/2020 |