Provider Demographics
NPI:1861645897
Name:ZHAO, SUIAN (LAC)
Entity Type:Individual
Prefix:
First Name:SUIAN
Middle Name:
Last Name:ZHAO
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 1:94-689 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3415
Mailing Address - Country:US
Mailing Address - Phone:808-676-7700
Mailing Address - Fax:808-676-7708
Practice Address - Street 1:85-885 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2440
Practice Address - Country:US
Practice Address - Phone:808-696-4764
Practice Address - Fax:808-696-2853
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-545171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist