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NPI 1417069386

NPI 1417069386 : DAFANG ZENG OMD., LAC. : WALNUT, CA

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General NPI Number Information
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    NPI Number           |    1417069386
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    Entity Type          |    Individual 
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    Provider Name        |    DAFANG ZENG OMD., LAC.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/31/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    20635 VALLEY BLVD #D
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    City                 |    WALNUT
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    State                |    CA
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    Zip                  |    91789-2744
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    Country              |    US
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    Telephone            |    909-444-9088
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    Fax                  |    909-595-9526
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Provider Business Mailing Address
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    Address Line         |    20635 VALLEY BLVD #D
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    City                 |    WALNUT
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    State                |    CA
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    Zip                  |    91789-2744
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    Country              |    US
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    Telephone            |    909-444-9088
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    Fax                  |    909-595-9526
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    AC4745
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    License Number State |    CA
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