Healthcare Provider Details

I. General information

NPI: 1750187555
Provider Name (Legal Business Name): QISCLINIC HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10011 N FOOTHILL BLVD STE 110
CUPERTINO CA
95014-5649
US

IV. Provider business mailing address

10011 N FOOTHILL BLVD STE 110
CUPERTINO CA
95014-5649
US

V. Phone/Fax

Practice location:
  • Phone: 669-250-1555
  • Fax:
Mailing address:
  • Phone: 669-250-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: XUEHONG FAN
Title or Position: CEO
Credential:
Phone: 669-250-1555