Provider Demographics
NPI:1083774574
Name:CHEN, BAO HE (LAC)
Entity Type:Individual
Prefix:MS
First Name:BAO
Middle Name:HE
Last Name:CHEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:426 S POMELO AV
Mailing Address - Street 2:#C
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755
Mailing Address - Country:US
Mailing Address - Phone:626-572-7748
Mailing Address - Fax:
Practice Address - Street 1:5814 TEMPLE CITY BL
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780
Practice Address - Country:US
Practice Address - Phone:626-285-1181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4248171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist