Provider Demographics
NPI:1518986694
Name:PHALEN, TAO SHA (MASTER OF ACUPUNCTUR)
Entity Type:Individual
Prefix:
First Name:TAO
Middle Name:SHA
Last Name:PHALEN
Suffix:
Gender:F
Credentials:MASTER OF ACUPUNCTUR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:909 ELECTRIC AVE
Mailing Address - Street 2:#312 (CHI OF LIFE)
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740
Mailing Address - Country:US
Mailing Address - Phone:562-598-3230
Mailing Address - Fax:714-901-1674
Practice Address - Street 1:909 ELECTRIC AVE
Practice Address - Street 2:#312
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740
Practice Address - Country:US
Practice Address - Phone:562-598-3230
Practice Address - Fax:714-901-1674
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10862171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist