Provider Demographics
NPI:1275887192
Name:CHAO, CHIA YING (LAC)
Entity Type:Individual
Prefix:
First Name:CHIA YING
Middle Name:
Last Name:CHAO
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 1:560 W MAIN ST
Mailing Address - Street 2:#C161
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3374
Mailing Address - Country:US
Mailing Address - Phone:626-537-7573
Mailing Address - Fax:
Practice Address - Street 1:45 AUTO CENTER DR
Practice Address - Street 2:STE 108
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2848
Practice Address - Country:US
Practice Address - Phone:949-855-8948
Practice Address - Fax:800-665-1218
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14861171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist