Provider Demographics
NPI:1811094436
Name:SHAO, XIAOHONG S (LAC,OMD)
Entity type:Individual
Prefix:MS
First Name:XIAOHONG
Middle Name:S
Last Name:SHAO
Suffix:
Gender:F
Credentials:LAC,OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4756 BARRANCA PKWY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4727
Mailing Address - Country:US
Mailing Address - Phone:949-653-1187
Mailing Address - Fax:949-653-1266
Practice Address - Street 1:4756 BARRANCA PKWY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4727
Practice Address - Country:US
Practice Address - Phone:949-653-1187
Practice Address - Fax:949-653-1266
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5232171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist