Provider Demographics
NPI:1427190198
Name:MARSHALL, ANITA CHEN (LAC)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:CHEN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2059 CLINTON AVE
Mailing Address - Street 2:SUITE#3
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4379
Mailing Address - Country:US
Mailing Address - Phone:510-523-1072
Mailing Address - Fax:510-523-1071
Practice Address - Street 1:2059 CLINTON AVE
Practice Address - Street 2:SUITE#3
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4379
Practice Address - Country:US
Practice Address - Phone:510-523-1072
Practice Address - Fax:510-523-1071
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6419171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist