Provider Demographics
NPI:1629474457
Name:XING, ZENGSHEN
Entity Type:Individual
Prefix:
First Name:ZENGSHEN
Middle Name:
Last Name:XING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 BAINBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-5112
Mailing Address - Country:US
Mailing Address - Phone:626-328-0137
Mailing Address - Fax:
Practice Address - Street 1:1737 BAINBRIDGE ST
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-5112
Practice Address - Country:US
Practice Address - Phone:626-328-0137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61727225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist