Provider Demographics
NPI:1346394103
Name:SHEN, QIONG ZHANG (ACUPUNCTURIST)
Entity Type:Individual
Prefix:DR
First Name:QIONG
Middle Name:ZHANG
Last Name:SHEN
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:DR
Other - First Name:JONATHAN
Other - Middle Name:KING
Other - Last Name:SHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACUPUNCTURIST
Mailing Address - Street 1:3309 BALBOA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2703
Mailing Address - Country:US
Mailing Address - Phone:415-876-6088
Mailing Address - Fax:
Practice Address - Street 1:3309 BALBOA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2703
Practice Address - Country:US
Practice Address - Phone:415-876-6088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4021171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist