Provider Demographics
NPI:1245009828
Name:DUAN, XUMIN
Entity type:Individual
Prefix:
First Name:XUMIN
Middle Name:
Last Name:DUAN
Suffix:
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 1:17671 IRVINE BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3128
Mailing Address - Country:US
Mailing Address - Phone:626-295-9570
Mailing Address - Fax:626-956-0911
Practice Address - Street 1:17671 IRVINE BLVD STE 116
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3128
Practice Address - Country:US
Practice Address - Phone:626-295-9570
Practice Address - Fax:626-956-0911
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19855171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist