Provider Demographics
NPI:1285191684
Name:TENG, QIFEI (LAC)
Entity Type:Individual
Prefix:
First Name:QIFEI
Middle Name:
Last Name:TENG
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 1:4063 MICHAEL AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4135
Mailing Address - Country:US
Mailing Address - Phone:650-505-8008
Mailing Address - Fax:
Practice Address - Street 1:46249 WARM SPRINGS BLVD # 1
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7026
Practice Address - Country:US
Practice Address - Phone:510-979-9298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18354171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist