Provider Demographics
NPI:1740636885
Name:GU, XIUQIONG
Entity type:Individual
Prefix:
First Name:XIUQIONG
Middle Name:
Last Name:GU
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 1:19119 COLIMA RD
Mailing Address - Street 2:STE 108A
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3010
Mailing Address - Country:US
Mailing Address - Phone:626-367-4896
Mailing Address - Fax:
Practice Address - Street 1:19119 COLIMA RD
Practice Address - Street 2:STE 108A
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-3010
Practice Address - Country:US
Practice Address - Phone:626-367-4896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-08
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17017171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist