Provider Demographics
NPI:1740356773
Name:ZHANG, GENGXIN
Entity type:Individual
Prefix:
First Name:GENGXIN
Middle Name:
Last Name:ZHANG
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 1:159 E LIVE OAK AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5251
Mailing Address - Country:US
Mailing Address - Phone:626-574-3038
Mailing Address - Fax:
Practice Address - Street 1:159 E LIVE OAK AVE
Practice Address - Street 2:108
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5249
Practice Address - Country:US
Practice Address - Phone:626-574-3038
Practice Address - Fax:626-574-9145
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3721171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist