Provider Demographics
NPI:1518334242
Name:BAI, JIAN ZHANG (LAC MS)
Entity Type:Individual
Prefix:
First Name:JIAN
Middle Name:ZHANG
Last Name:BAI
Suffix:
Gender:M
Credentials:LAC MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 CORBETT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2250
Mailing Address - Country:US
Mailing Address - Phone:415-939-5681
Mailing Address - Fax:
Practice Address - Street 1:607 CORBETT AVE APT 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2250
Practice Address - Country:US
Practice Address - Phone:415-939-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16584171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist