Provider Demographics
NPI:1245463942
Name:CHAO, TIEN YOU (LAC)
Entity type:Individual
Prefix:
First Name:TIEN
Middle Name:YOU
Last Name:CHAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5032
Mailing Address - Country:US
Mailing Address - Phone:408-287-7888
Mailing Address - Fax:408-287-7888
Practice Address - Street 1:131 E TAYLOR ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5032
Practice Address - Country:US
Practice Address - Phone:408-287-7888
Practice Address - Fax:408-287-7888
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9823171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist