Provider Demographics
NPI:1225268725
Name:GU, NAI-QIANG (LAC)
Entity Type:Individual
Prefix:
First Name:NAI-QIANG
Middle Name:
Last Name:GU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5020 BUTTERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4303
Mailing Address - Country:US
Mailing Address - Phone:310-838-2388
Mailing Address - Fax:
Practice Address - Street 1:1807 WILSHIRE BLVD STE B
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5678
Practice Address - Country:US
Practice Address - Phone:310-453-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7224171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist