Provider Demographics
NPI:1225878986
Name:CHEN, WINSON (DACM, LAC)
Entity type:Individual
Prefix:MR
First Name:WINSON
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:DACM, LAC
Other - Prefix:MR
Other - First Name:WINSON
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DACM
Mailing Address - Street 1:17705 HALE AVE STE C2
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-4316
Mailing Address - Country:US
Mailing Address - Phone:408-779-1634
Mailing Address - Fax:
Practice Address - Street 1:17705 HALE AVE STE C2
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-4316
Practice Address - Country:US
Practice Address - Phone:408-779-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17571171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist