Provider Demographics
NPI:1841206174
Name:ZHANG, QINRONG (LAC)
Entity Type:Individual
Prefix:DR
First Name:QINRONG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15574 GALE AVE
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-1513
Mailing Address - Country:US
Mailing Address - Phone:626-961-9596
Mailing Address - Fax:626-961-8594
Practice Address - Street 1:15574 GALE AVE
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-1513
Practice Address - Country:US
Practice Address - Phone:626-961-9596
Practice Address - Fax:626-961-8594
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5089171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist