Provider Demographics
NPI:1679771406
Name:JIN, SHAO HUI (LAC)
Entity Type:Individual
Prefix:MR
First Name:SHAO
Middle Name:HUI
Last Name:JIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:5730 N WILLARD AVE
Mailing Address - Street 2:APT 3H
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775
Mailing Address - Country:US
Mailing Address - Phone:949-376-6869
Mailing Address - Fax:949-376-6869
Practice Address - Street 1:1400 S COAST HWY
Practice Address - Street 2:SUIT 200
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651
Practice Address - Country:US
Practice Address - Phone:949-376-6869
Practice Address - Fax:949-376-6869
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC8141171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist