Provider Demographics
NPI:1649441585
Name:CHEN, SHUN SHENG (LAC, OMD)
Entity type:Individual
Prefix:MR
First Name:SHUN
Middle Name:SHENG
Last Name:CHEN
Suffix:
Gender:M
Credentials:LAC, OMD
Other - Prefix:MR
Other - First Name:SAMUEL
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, OMD
Mailing Address - Street 1:9179 VALLEY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5803
Mailing Address - Country:US
Mailing Address - Phone:714-527-0099
Mailing Address - Fax:714-821-1610
Practice Address - Street 1:9179 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5803
Practice Address - Country:US
Practice Address - Phone:714-527-0099
Practice Address - Fax:714-821-1610
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 10052171100000X
CAAC 10353171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist