Provider Demographics
NPI:1740696244
Name:FU, XINING (OMD PHD LAC)
Entity type:Individual
Prefix:DR
First Name:XINING
Middle Name:
Last Name:FU
Suffix:
Gender:F
Credentials:OMD PHD LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N. JACKSON AVE.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116
Mailing Address - Country:US
Mailing Address - Phone:408-929-4837
Mailing Address - Fax:
Practice Address - Street 1:125 N JACKSON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1903
Practice Address - Country:US
Practice Address - Phone:408-929-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3525171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist