Provider Demographics
NPI:1437279593
Name:XIE, ZHICHAO (LAC)
Entity type:Individual
Prefix:
First Name:ZHICHAO
Middle Name:
Last Name:XIE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 W DUARTE RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9160
Mailing Address - Country:US
Mailing Address - Phone:626-446-6395
Mailing Address - Fax:
Practice Address - Street 1:3223 DEL MAR AVE # 101
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2327
Practice Address - Country:US
Practice Address - Phone:626-280-9608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 5985171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist