Provider Demographics
NPI:1124201595
Name:FANG, XIU ZHEN (L AC)
Entity Type:Individual
Prefix:MS
First Name:XIU
Middle Name:ZHEN
Last Name:FANG
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 HALLOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3459
Mailing Address - Country:US
Mailing Address - Phone:626-215-3806
Mailing Address - Fax:
Practice Address - Street 1:2885 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4311
Practice Address - Country:US
Practice Address - Phone:626-215-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-08
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 6057171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist