Provider Demographics
NPI:1659495596
Name:MA, SU-CHEN (L AC)
Entity Type:Individual
Prefix:MS
First Name:SU-CHEN
Middle Name:
Last Name:MA
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W VALLEY BLVD STE 217
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3759
Mailing Address - Country:US
Mailing Address - Phone:626-281-8987
Mailing Address - Fax:
Practice Address - Street 1:301 W VALLEY BLVD STE 217
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3759
Practice Address - Country:US
Practice Address - Phone:626-281-8987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4864171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist