Provider Demographics
NPI:1265170955
Name:LING, JUDY SHAN CHIN (LAC)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:SHAN CHIN
Last Name:LING
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:DR
Other - First Name:JUDY
Other - Middle Name:S
Other - Last Name:LING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:13843 REVA ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9061
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13843 REVA ST
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-9061
Practice Address - Country:US
Practice Address - Phone:310-686-4013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19446171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist