Healthcare Provider Details

I. General information

NPI: 1558678201
Provider Name (Legal Business Name): MS. XIAOQIN ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 EL CAMINO REAL SUITE 4
SOUTH SAN FRANCISCO CA
94080-5977
US

IV. Provider business mailing address

343 EL CAMINO REAL SUITE 4
SOUTH SAN FRANCISCO CA
94080-1123
US

V. Phone/Fax

Practice location:
  • Phone: 415-994-7267
  • Fax:
Mailing address:
  • Phone: 415-994-7267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: