Provider Demographics
NPI:1164588539
Name:JIA, WEIHONG (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MS
First Name:WEIHONG
Middle Name:
Last Name:JIA
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 ARTESIA BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3100
Mailing Address - Country:US
Mailing Address - Phone:310-217-9088
Mailing Address - Fax:
Practice Address - Street 1:2301 ARTESIA BLVD STE 6
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3100
Practice Address - Country:US
Practice Address - Phone:310-217-9088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5812171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist