Healthcare Provider Details

I. General information

NPI: 1538205604
Provider Name (Legal Business Name): XIAN SHENG HUANG L.AC.,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 7TH ST
OAKLAND CA
94607-3928
US

IV. Provider business mailing address

39 NACE AVE
PIEDMONT CA
94611-4325
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-1080
  • Fax: 510-835-3167
Mailing address:
  • Phone: 510-835-1080
  • Fax: 510-835-3167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC3332
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: