Provider Demographics
NPI:1124587480
Name:BI, SHAOFANG
Entity Type:Individual
Prefix:
First Name:SHAOFANG
Middle Name:
Last Name:BI
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 1:10370 CALVERT DR
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3872
Mailing Address - Country:US
Mailing Address - Phone:408-797-6074
Mailing Address - Fax:
Practice Address - Street 1:10370 CALVERT DR
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3872
Practice Address - Country:US
Practice Address - Phone:408-797-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-17
Last Update Date:2019-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18423171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist