Provider Demographics
NPI:1669493094
Name:BIEN, RICHARD SOUNG (PT,LAC, PHD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:SOUNG
Last Name:BIEN
Suffix:
Gender:M
Credentials:PT,LAC, PHD
Other - Prefix:
Other - First Name:SOUNG
Other - Middle Name:HO
Other - Last Name:BIEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:1401 S BROOKHURST RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-4403
Mailing Address - Country:US
Mailing Address - Phone:714-446-0708
Mailing Address - Fax:714-446-8708
Practice Address - Street 1:1401 S BROOKHURST RD
Practice Address - Street 2:SUITE 105
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-4403
Practice Address - Country:US
Practice Address - Phone:714-446-0708
Practice Address - Fax:714-446-8708
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT14242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC3739OtherACUPUNCTURIST LICENSE
CA0PT142420OtherBLUE SHIELD PROVIDER NUMB
CAPT14242OtherPT LICENSE
CAPT14242CMedicare ID - Type UnspecifiedPROVIDER NUMBER
CAPT14242AMedicare ID - Type UnspecifiedPROVIDER NUMBER
CAPT14242BMedicare ID - Type UnspecifiedPROVIDER NUMBER