Provider Demographics
NPI:1831170786
Name:CHUANG, GINA HUA QIN (LAC)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:HUA QIN
Last Name:CHUANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:HUA
Other - Middle Name:Q
Other - Last Name:CHUANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4849 VAN NUYS BLVD
Mailing Address - Street 2:SUITE #206
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403
Mailing Address - Country:US
Mailing Address - Phone:818-386-0629
Mailing Address - Fax:818-386-0891
Practice Address - Street 1:4849 VAN NUYS BLVD
Practice Address - Street 2:SUITE #206
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403
Practice Address - Country:US
Practice Address - Phone:818-386-0629
Practice Address - Fax:818-386-0891
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7175171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA0071751OtherBLUE SHIELD
CACAQ071750OtherBLUE SHIELD