Provider Demographics
NPI:1619131885
Name:GAO, XUHONG (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:XUHONG
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:XUHONG
Other - Middle Name:
Other - Last Name:GAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5557 E SANTA ANA CANYON RD
Mailing Address - Street 2:#207
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3128
Mailing Address - Country:US
Mailing Address - Phone:714-921-8888
Mailing Address - Fax:
Practice Address - Street 1:5557 E SANTA ANA CANYON RD
Practice Address - Street 2:#207
Practice Address - City:ANAHEIM HILLS
Practice Address - State:CA
Practice Address - Zip Code:92807-3128
Practice Address - Country:US
Practice Address - Phone:714-921-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC8509171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALAC8509Medicaid