Provider Demographics
NPI:1982035028
Name:ALCOCER, XIAOLONG (LAC)
Entity Type:Individual
Prefix:MR
First Name:XIAOLONG
Middle Name:
Last Name:ALCOCER
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 1:23468 SEAFARER WAY
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557
Mailing Address - Country:US
Mailing Address - Phone:626-377-0699
Mailing Address - Fax:
Practice Address - Street 1:23887 SUNNYMEAD BLVD., SUITE C
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553
Practice Address - Country:US
Practice Address - Phone:626-377-0699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15737171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist