Healthcare Provider Details

I. General information

NPI: 1003458167
Provider Name (Legal Business Name): GENE KOU XIONG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9381 E STOCKTON BLVD STE 204
ELK GROVE CA
95624-5070
US

IV. Provider business mailing address

9381 E STOCKTON BLVD STE 204
ELK GROVE CA
95624-5070
US

V. Phone/Fax

Practice location:
  • Phone: 916-639-6059
  • Fax:
Mailing address:
  • Phone: 209-756-9516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number34583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: