Provider Demographics
NPI:1871030544
Name:ZHU, XIAONING I
Entity Type:Individual
Prefix:
First Name:XIAONING
Middle Name:
Last Name:ZHU
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2147 EVENINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1421
Mailing Address - Country:US
Mailing Address - Phone:626-592-5280
Mailing Address - Fax:
Practice Address - Street 1:2147 EVENINGSIDE DR
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1421
Practice Address - Country:US
Practice Address - Phone:626-592-5280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14956171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist