Healthcare Provider Details

I. General information

NPI: 1578924437
Provider Name (Legal Business Name): QIAN ZHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 ARDEN AVE 100
GLENDALE CA
91203-1127
US

IV. Provider business mailing address

410 ARDEN AVE 100
GLENDALE CA
91203-1127
US

V. Phone/Fax

Practice location:
  • Phone: 818-500-9562
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 16853
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: