Provider Demographics
NPI:1407190275
Name:CHEN, KUANG LIANG (15116)
Entity Type:Individual
Prefix:MR
First Name:KUANG
Middle Name:LIANG
Last Name:CHEN
Suffix:
Gender:M
Credentials:15116
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:15116
Mailing Address - Street 1:4444 PEPPERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1348
Mailing Address - Country:US
Mailing Address - Phone:562-888-3399
Mailing Address - Fax:
Practice Address - Street 1:5855 E NAPLES PLZ STE 111
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5077
Practice Address - Country:US
Practice Address - Phone:562-888-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15116171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist