Provider Demographics
NPI:1609215474
Name:ZHANG, XUEWEN (LAC, PHD)
Entity Type:Individual
Prefix:MR
First Name:XUEWEN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14471 CHAMBERS RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6969
Mailing Address - Country:US
Mailing Address - Phone:626-373-6037
Mailing Address - Fax:
Practice Address - Street 1:14471 CHAMBERS RD STE 105
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6969
Practice Address - Country:US
Practice Address - Phone:626-373-6037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2023-04-28
Deactivation Date:2023-04-01
Deactivation Code:
Reactivation Date:2023-04-20
Provider Licenses
StateLicense IDTaxonomies
CAAC 15490171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist