Provider Demographics
NPI:1073654653
Name:CHEN CHIROPRACTIC INTEGRATIVE HEALTH CENTER
Entity Type:Organization
Organization Name:CHEN CHIROPRACTIC INTEGRATIVE HEALTH CENTER
Other - Org Name:AXIS INTEGRATIVE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:HSIN
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:626-444-5130
Mailing Address - Street 1:10053 VALLEY BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-1764
Mailing Address - Country:US
Mailing Address - Phone:626-444-5130
Mailing Address - Fax:626-444-5131
Practice Address - Street 1:10053 VALLEY BLVD STE 7
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-1764
Practice Address - Country:US
Practice Address - Phone:626-444-5130
Practice Address - Fax:626-444-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29121111N00000X
CAAC10172171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty