Provider Demographics
NPI:1386346971
Name:WEN, CHUN
Entity type:Individual
Prefix:
First Name:CHUN
Middle Name:
Last Name:WEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W WILSHIRE AVE APT 126
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1855
Mailing Address - Country:US
Mailing Address - Phone:626-759-4373
Mailing Address - Fax:
Practice Address - Street 1:141 W WILSHIRE AVE APT 126
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1855
Practice Address - Country:US
Practice Address - Phone:626-759-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19692171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist