MEDICARE: QIU SHUANG XU

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	LAC5670	CA

General Provider Information

NPI Number	:	1639333818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QIU SHUANG XU

Provider Business Mailing Address
First Line	:	16028 E. GALE AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16028 E. GALE AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1605
Country	:	US
Telephone Number	:	562-860-9989
Fax Number	:

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

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/28/2015

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Directions to “ QIU SHUANG XU ” Practice Location

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