Provider Demographics
NPI:1093938292
Name:CHEN, XINMING
Entity Type:Individual
Prefix:
First Name:XINMING
Middle Name:
Last Name:CHEN
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 1:1221 MICHIGAN AVE APT A
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-4330
Mailing Address - Country:US
Mailing Address - Phone:310-384-4908
Mailing Address - Fax:310-390-1868
Practice Address - Street 1:1221 MICHIGAN AVE APT A
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-4330
Practice Address - Country:US
Practice Address - Phone:310-384-4908
Practice Address - Fax:310-390-1868
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6726171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist