Provider Demographics
NPI:1295066496
Name:MENG, CHARLES (AC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:MENG
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:QINGLIN
Other - Middle Name:
Other - Last Name:MENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AC
Mailing Address - Street 1:8736 VALLEY BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1760
Mailing Address - Country:US
Mailing Address - Phone:626-569-9001
Mailing Address - Fax:626-569-9017
Practice Address - Street 1:8736 VALLEY BLVD STE D
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1760
Practice Address - Country:US
Practice Address - Phone:626-569-9001
Practice Address - Fax:626-569-9017
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8078171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist