Provider Demographics
NPI:1710136486
Name:XU, XINGSHENG (LAC 10710)
Entity Type:Individual
Prefix:
First Name:XINGSHENG
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:LAC 10710
Other - Prefix:
Other - First Name:LUKE
Other - Middle Name:
Other - Last Name:XU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC 10710
Mailing Address - Street 1:1080 E. BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776
Mailing Address - Country:US
Mailing Address - Phone:626-233-9555
Mailing Address - Fax:626-308-0605
Practice Address - Street 1:1080 E. BROADWAY
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776
Practice Address - Country:US
Practice Address - Phone:626-233-9555
Practice Address - Fax:626-308-0605
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10710171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist