Provider Demographics
NPI:1043220536
Name:CHEN, QIAN (LAC)
Entity Type:Individual
Prefix:MS
First Name:QIAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E. PALMDALE BLVD
Mailing Address - Street 2:#A
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4594
Mailing Address - Country:US
Mailing Address - Phone:661-947-1556
Mailing Address - Fax:661-947-1667
Practice Address - Street 1:235 E PALMDALE BLVD STE A
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4594
Practice Address - Country:US
Practice Address - Phone:661-947-1556
Practice Address - Fax:661-947-1667
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9464171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist