Provider Demographics
NPI:1083490817
Name:MENG, HAIJIAO
Entity Type:Individual
Prefix:
First Name:HAIJIAO
Middle Name:
Last Name:MENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SYMPHONY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-0690
Mailing Address - Country:US
Mailing Address - Phone:949-350-0485
Mailing Address - Fax:
Practice Address - Street 1:117 SYMPHONY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92603-0690
Practice Address - Country:US
Practice Address - Phone:949-350-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19735171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty