Provider Demographics
NPI:1649344730
Name:SHEN, XIAOXIONG (PH D, LAC, PROF)
Entity type:Individual
Prefix:DR
First Name:XIAOXIONG
Middle Name:
Last Name:SHEN
Suffix:
Gender:M
Credentials:PH D, LAC, PROF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 W ARTESIA BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-3370
Mailing Address - Country:US
Mailing Address - Phone:310-327-0336
Mailing Address - Fax:
Practice Address - Street 1:1328 W ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-3370
Practice Address - Country:US
Practice Address - Phone:310-327-0336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8507171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist