Provider Demographics
NPI:1346532959
Name:GUO, QI (LAC)
Entity Type:Individual
Prefix:MS
First Name:QI
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 OCEAN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3140
Mailing Address - Country:US
Mailing Address - Phone:650-468-1024
Mailing Address - Fax:
Practice Address - Street 1:840 OCEAN VIEW AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3140
Practice Address - Country:US
Practice Address - Phone:650-468-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-15
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14349171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist