Provider Demographics
NPI:1912491788
Name:GUO, SHAOQING
Entity Type:Individual
Prefix:MRS
First Name:SHAOQING
Middle Name:
Last Name:GUO
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 1:2625 UNIVERSITY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0411
Mailing Address - Country:US
Mailing Address - Phone:225-288-0686
Mailing Address - Fax:225-767-7134
Practice Address - Street 1:4545 BLUEBONNET BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-5602
Practice Address - Country:US
Practice Address - Phone:225-766-2311
Practice Address - Fax:225-767-7134
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAACA.C20019171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist