Provider Demographics
NPI:1295820033
Name:XIAO, QINGSONG (PHD, O M D, LAC)
Entity Type:Individual
Prefix:DR
First Name:QINGSONG
Middle Name:
Last Name:XIAO
Suffix:
Gender:F
Credentials:PHD, O M D, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3337 N MILLER RD
Mailing Address - Street 2:STE103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6495
Mailing Address - Country:US
Mailing Address - Phone:480-429-8881
Mailing Address - Fax:480-429-8882
Practice Address - Street 1:3337 N MILLER RD
Practice Address - Street 2:STE103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6495
Practice Address - Country:US
Practice Address - Phone:480-429-8881
Practice Address - Fax:480-429-8882
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0522171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0522OtherACUPUNCTURE