MEDICARE: JIA FENG

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	20302	CA

General Provider Information

NPI Number	:	1912708017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIA FENG

Provider Business Mailing Address
First Line	:	2130 HUNTINGTON DR STE 313
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4980
Country	:	US
Telephone Number	:	626-675-4599
Fax Number	:

Provider Business Practice Location Address
First Line	:	2130 HUNTINGTON DR STE 313
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4980
Country	:	US
Telephone Number	:	626-675-4599
Fax Number	:

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

Provider Enumeration Date	:	03/24/2025
Last Update Date	:	04/24/2025

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Directions to “ JIA FENG ” Practice Location

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