Provider Demographics
NPI:1326103870
Name:XIN, CHANGSHAN
Entity Type:Individual
Prefix:MR
First Name:CHANGSHAN
Middle Name:
Last Name:XIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17544 ORLON DR
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-4129
Mailing Address - Country:US
Mailing Address - Phone:626-369-0998
Mailing Address - Fax:626-965-3395
Practice Address - Street 1:3042 S HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-5313
Practice Address - Country:US
Practice Address - Phone:626-369-0998
Practice Address - Fax:626-965-3395
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7726171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist