Provider Demographics
NPI:1538205604
Name:HUANG, XIAN SHENG (LAC,)
Entity type:Individual
Prefix:
First Name:XIAN
Middle Name:SHENG
Last Name:HUANG
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 1:39 NACE AVE
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4325
Mailing Address - Country:US
Mailing Address - Phone:510-835-1080
Mailing Address - Fax:510-835-3167
Practice Address - Street 1:408 7TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-3928
Practice Address - Country:US
Practice Address - Phone:510-835-1080
Practice Address - Fax:510-835-3167
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3332171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0033320Medicaid