Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC27400 | CA |
NPI | 1295948263 |
---|---|
Provider Name | Terhsiu Chen |
First Address | Rosemead, CA 91770 |
Second Address | Rosemead, CA 91770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC27400 | LICENCE (01) | CA |