Provider Demographics
NPI:1932270865
Name:CHEN, IRENE E (LAC)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:E
Last Name:CHEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 1/2 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-1849
Mailing Address - Country:US
Mailing Address - Phone:626-380-6465
Mailing Address - Fax:
Practice Address - Street 1:5610 1/2 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-1849
Practice Address - Country:US
Practice Address - Phone:626-380-6465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA9111171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist