Provider Demographics
NPI:1447558283
Name:ELLIS, HSIAO CHIEN (LAC)
Entity Type:Individual
Prefix:
First Name:HSIAO CHIEN
Middle Name:
Last Name:ELLIS
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 1:16161 VENTURA BLVD
Mailing Address - Street 2:STE 106
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2522
Mailing Address - Country:US
Mailing Address - Phone:310-889-4541
Mailing Address - Fax:818-995-4301
Practice Address - Street 1:16161 VENTURA BLVD
Practice Address - Street 2:STE 106
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2522
Practice Address - Country:US
Practice Address - Phone:310-889-4541
Practice Address - Fax:818-995-4301
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14060171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist