Provider Demographics
NPI:1659031474
Name:BRUHWILER, CHAUCHABAR (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MRS
First Name:CHAUCHABAR
Middle Name:
Last Name:BRUHWILER
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 133217
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92315-8917
Mailing Address - Country:US
Mailing Address - Phone:310-463-3347
Mailing Address - Fax:
Practice Address - Street 1:265 CRYSTAL LAKE RD APT 6
Practice Address - Street 2:
Practice Address - City:BIG BEAR LAKE
Practice Address - State:CA
Practice Address - Zip Code:92315-2386
Practice Address - Country:US
Practice Address - Phone:310-463-3347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11080225700000X
CACA19552171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist