=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003022252
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | XUEBIN WANG CHIROPRACTIC, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2007
-----------------------------------------------------
Last Update Date | 08/22/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1635 CRENSHAW BLVD
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-3123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-328-8898
-----------------------------------------------------
Fax | 310-328-8896
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1635 CRENSHAW BLVD
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-3123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-328-8898
-----------------------------------------------------
Fax | 310-328-8896
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | XUEBIN WANG
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 310-328-8898
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC3510
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC21188
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------