Provider Demographics
NPI:1528222684
Name:CHEN, PAULA (LAC OMD)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:LAC OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1393 SANTA RITA RD
Mailing Address - Street 2:STE D
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566
Mailing Address - Country:US
Mailing Address - Phone:925-461-2840
Mailing Address - Fax:925-461-2844
Practice Address - Street 1:1491 CEDARWOOD LANE
Practice Address - Street 2:#D
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566
Practice Address - Country:US
Practice Address - Phone:925-461-2840
Practice Address - Fax:925-461-2844
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC431171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist