=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407368368
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. XIANGPING XIE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2017
-----------------------------------------------------
Last Update Date | 11/01/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1520 SOUTHWEST EXPY APT 141
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95126-3984
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-398-9896
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1745 NANTUCKET CIR APT 361
-----------------------------------------------------
City | SANTA CLARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95054-3820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-398-9896
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 17775
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------