Provider Demographics
NPI:1518011394
Name:CHEN ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:CHEN ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEARL
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:480-609-8555
Mailing Address - Street 1:5644 W ABRAHAM LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6202
Mailing Address - Country:US
Mailing Address - Phone:480-609-8555
Mailing Address - Fax:623-875-9089
Practice Address - Street 1:10814 N SCOTTSDALE RD
Practice Address - Street 2:SUITE B
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6166
Practice Address - Country:US
Practice Address - Phone:480-609-8555
Practice Address - Fax:623-875-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0059171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty