Provider Demographics
NPI:1922332444
Name:FENG, DAVID SHOUDAO (LAC, OMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SHOUDAO
Last Name:FENG
Suffix:
Gender:M
Credentials:LAC, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3453
Mailing Address - Country:US
Mailing Address - Phone:714-879-3965
Mailing Address - Fax:714-879-3965
Practice Address - Street 1:1781 W ROMNEYA DR
Practice Address - Street 2:# F
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1818
Practice Address - Country:US
Practice Address - Phone:714-612-8490
Practice Address - Fax:714-879-3965
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7615171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist