Provider Demographics
NPI:1013054261
Name:FANG, HSIEN (LAC)
Entity type:Individual
Prefix:MR
First Name:HSIEN
Middle Name:
Last Name:FANG
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 1:180 N DOMMER AVE.
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789
Mailing Address - Country:US
Mailing Address - Phone:626-710-6055
Mailing Address - Fax:909-598-8567
Practice Address - Street 1:3131 SANTA ANITA AVE. #202
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733
Practice Address - Country:US
Practice Address - Phone:626-710-6055
Practice Address - Fax:909-598-8567
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8492171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist