Healthcare Provider Details

I. General information

NPI: 1033352216
Provider Name (Legal Business Name): JING ZHEN QIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N MCPHERRIN AVE
MONTEREY PARK CA
91754-1644
US

IV. Provider business mailing address

125 N MCPHERRIN AVE
MONTEREY PARK CA
91754-1644
US

V. Phone/Fax

Practice location:
  • Phone: 626-808-1164
  • Fax:
Mailing address:
  • Phone: 626-808-1164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12863
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: