Provider Demographics
NPI:1235425240
Name:XIN DU, A MEDICAL CORP
Entity Type:Organization
Organization Name:XIN DU, A MEDICAL CORP
Other - Org Name:NEWX ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:XIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DU
Authorized Official - Suffix:
Authorized Official - Credentials:OMD
Authorized Official - Phone:951-582-9627
Mailing Address - Street 1:124 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3320
Mailing Address - Country:US
Mailing Address - Phone:951-582-9627
Mailing Address - Fax:951-582-0345
Practice Address - Street 1:124 W 9TH ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3320
Practice Address - Country:US
Practice Address - Phone:951-582-9627
Practice Address - Fax:951-582-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5684171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty