Provider Demographics
NPI:1265991541
Name:XUE, JIN LIAN
Entity type:Individual
Prefix:
First Name:JIN
Middle Name:LIAN
Last Name:XUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 HUMBOLDT RD
Mailing Address - Street 2:
Mailing Address - City:BRISBANE
Mailing Address - State:CA
Mailing Address - Zip Code:94005-1305
Mailing Address - Country:US
Mailing Address - Phone:415-297-0103
Mailing Address - Fax:415-297-0103
Practice Address - Street 1:288 HUMBOLDT RD
Practice Address - Street 2:
Practice Address - City:BRISBANE
Practice Address - State:CA
Practice Address - Zip Code:94005-1305
Practice Address - Country:US
Practice Address - Phone:415-297-0103
Practice Address - Fax:415-297-0103
Is Sole Proprietor?:No
Enumeration Date:2019-03-17
Last Update Date:2019-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18459171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist