MEDICARE: MR. CHANGSHAN XIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	7726	CA

General Provider Information

NPI Number	:	1326103870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHANGSHAN XIN

Provider Business Mailing Address
First Line	:	17544 ORLON DR
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-4129
Country	:	US
Telephone Number	:	626-369-0998
Fax Number	:	626-965-3395

Provider Business Practice Location Address
First Line	:	3042 S HACIENDA BLVD
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-5313
Country	:	US
Telephone Number	:	626-369-0998
Fax Number	:	626-965-3395

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. CHANGSHAN XIN ” Practice Location

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