Provider Demographics
NPI:1508373531
Name:ZHONG, QINGHUI (LAC)
Entity Type:Individual
Prefix:MR
First Name:QINGHUI
Middle Name:
Last Name:ZHONG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4643 NORWOOD TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4053
Mailing Address - Country:US
Mailing Address - Phone:510-456-5794
Mailing Address - Fax:
Practice Address - Street 1:2147 MOWRY AVE STE D3
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1724
Practice Address - Country:US
Practice Address - Phone:510-456-5794
Practice Address - Fax:510-894-1205
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17876171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist