Provider Demographics
NPI:1619485158
Name:CHEN CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:CHEN CHIROPRACTIC CLINIC INC
Other - Org Name:SUMMIT HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:WUU
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-623-8684
Mailing Address - Street 1:18575 GALE AVE STE 265
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1384
Mailing Address - Country:US
Mailing Address - Phone:626-623-8684
Mailing Address - Fax:626-608-2665
Practice Address - Street 1:18575 GALE AVE STE 265
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1384
Practice Address - Country:US
Practice Address - Phone:626-623-8684
Practice Address - Fax:626-608-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty