Provider Demographics
NPI:1528192135
Name:GENGXIN ZHANG ACUPUNCTURIST INC
Entity Type:Organization
Organization Name:GENGXIN ZHANG ACUPUNCTURIST INC
Other - Org Name:LIVE OAK NATURAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:L.A.C.
Authorized Official - Prefix:MR
Authorized Official - First Name:GENGXIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC PHD DMD
Authorized Official - Phone:626-574-3038
Mailing Address - Street 1:159 E LIVE OAK AVE
Mailing Address - Street 2:#108
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5251
Mailing Address - Country:US
Mailing Address - Phone:626-574-3038
Mailing Address - Fax:626-574-9145
Practice Address - Street 1:159 E LIVE OAK AVE
Practice Address - Street 2:#108
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5251
Practice Address - Country:US
Practice Address - Phone:626-574-3038
Practice Address - Fax:626-574-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3721171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902849367OtherMD
CA1740356773OtherACUPUNCTURIST