Provider Demographics
NPI:1477596013
Name:CHAO, XIUJUAN ZHEN (LAC)
Entity Type:Individual
Prefix:DR
First Name:XIUJUAN
Middle Name:ZHEN
Last Name:CHAO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:DR
Other - First Name:XIU-JUAN
Other - Middle Name:ZHEN
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:12915 FLACK ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-4066
Mailing Address - Country:US
Mailing Address - Phone:301-949-0115
Mailing Address - Fax:301-949-0115
Practice Address - Street 1:12915 FLACK ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-4066
Practice Address - Country:US
Practice Address - Phone:301-949-0115
Practice Address - Fax:301-949-0115
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500023171100000X
VA0121000399171100000X
MDU01443171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist