Provider Demographics
NPI:1396780177
Name:ZHONG-FONG, PEI LI (LAC)
Entity type:Individual
Prefix:MS
First Name:PEI LI
Middle Name:
Last Name:ZHONG-FONG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:PEI LI
Other - Middle Name:
Other - Last Name:ZHONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:1949 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-4989
Mailing Address - Country:US
Mailing Address - Phone:626-799-8855
Mailing Address - Fax:626-799-1099
Practice Address - Street 1:1949 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4989
Practice Address - Country:US
Practice Address - Phone:626-799-8855
Practice Address - Fax:626-799-1099
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2837171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist