Provider Demographics
NPI:1841417847
Name:HOM, FARLEY CHUI (LAC, OTRL)
Entity Type:Individual
Prefix:MR
First Name:FARLEY
Middle Name:CHUI
Last Name:HOM
Suffix:
Gender:M
Credentials:LAC, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 JASMINE AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-5954
Mailing Address - Country:US
Mailing Address - Phone:310-561-5657
Mailing Address - Fax:
Practice Address - Street 1:2990 S SEPULVEDA BLVD
Practice Address - Street 2:SIUTE 205
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-0002
Practice Address - Country:US
Practice Address - Phone:310-561-5657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10759171100000X
CA5481174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist