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General NPI Number Information
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NPI Number | 1912418492
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Entity Type | Individual
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Provider Name | CHUNMING HSIAO L.AC
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Gender | Male
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 22706 ASPAN ST STE 300
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City | LAKE FOREST
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State | CA
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Zip | 92630-1603
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Country | US
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Telephone | 949-472-6391
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Fax | 949-472-6414
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Provider Business Mailing Address
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Address Line | 1 LEAGUE UNIT 61562
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City | IRVINE
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State | CA
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Zip | 92602-7072
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Country | US
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Telephone |
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Fax |
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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 | AC17765
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 33154
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License Number State | CA
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