Provider Demographics
NPI:1649309758
Name:TAI, CHUEH CHIAO (L AC,)
Entity type:Individual
Prefix:MS
First Name:CHUEH CHIAO
Middle Name:
Last Name:TAI
Suffix:
Gender:F
Credentials:L AC,
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:TAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OMD
Mailing Address - Street 1:3747 MIRTOON SEA AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-7617
Mailing Address - Country:US
Mailing Address - Phone:916-671-4838
Mailing Address - Fax:
Practice Address - Street 1:8355 ELK GROVE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5517
Practice Address - Country:US
Practice Address - Phone:916-671-4838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 15876171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist