Provider Demographics
NPI:1427277532
Name:CHAU TIERNEY, AMY MEI LIN
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MEI LIN
Last Name:CHAU TIERNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MEI LIN
Other - Last Name:CHAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:960 E GREEN ST
Mailing Address - Street 2:SUITE L-2
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2412
Mailing Address - Country:US
Mailing Address - Phone:818-915-5221
Mailing Address - Fax:626-521-6082
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:SUITE L-2
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2412
Practice Address - Country:US
Practice Address - Phone:818-915-5221
Practice Address - Fax:626-521-6082
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA702394OtherACN GROUP