Provider Demographics
NPI:1689908139
Name:ZHANG, TIAN MING (LA C)
Entity Type:Individual
Prefix:
First Name:TIAN MING
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:LA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16303 GRAMERCY PLACE
Mailing Address - Street 2:APT. 4
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247
Mailing Address - Country:US
Mailing Address - Phone:310-532-2912
Mailing Address - Fax:
Practice Address - Street 1:16303 GRAMERCY PLACE
Practice Address - Street 2:APT. 4
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247
Practice Address - Country:US
Practice Address - Phone:310-532-2912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12720171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist