Provider Demographics
NPI:1417352758
Name:JIN, GUISHU
Entity Type:Individual
Prefix:
First Name:GUISHU
Middle Name:
Last Name:JIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 DICHA DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-0174
Mailing Address - Country:US
Mailing Address - Phone:805-280-6288
Mailing Address - Fax:
Practice Address - Street 1:331 S C ST STE D
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-5825
Practice Address - Country:US
Practice Address - Phone:805-272-1166
Practice Address - Fax:805-272-1167
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9967171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist