Provider Demographics
NPI:1811438237
Name:FENG, HAI QI XU
Entity type:Individual
Prefix:
First Name:HAI QI
Middle Name:XU
Last Name:FENG
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 1:747 AMANA ST
Mailing Address - Street 2:APT 1816
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-5100
Mailing Address - Country:US
Mailing Address - Phone:808-308-9880
Mailing Address - Fax:
Practice Address - Street 1:747 AMANA ST
Practice Address - Street 2:APT 1816
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-5100
Practice Address - Country:US
Practice Address - Phone:808-308-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-18
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-14335225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty