Provider Demographics
NPI:1730463563
Name:R. CHEN CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:R. CHEN CHIROPRACTIC, INC.
Other - Org Name:LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBBY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-468-2192
Mailing Address - Street 1:20905 GOLDEN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91789-3806
Mailing Address - Country:US
Mailing Address - Phone:909-468-2192
Mailing Address - Fax:
Practice Address - Street 1:20905 GOLDEN SPRINGS DR
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91789-3806
Practice Address - Country:US
Practice Address - Phone:909-468-2192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30668111NR0400X
CAPT29435225100000X
225200000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty