Provider Demographics
NPI:1548044555
Name:PIAO, FENGJI
Entity type:Individual
Prefix:
First Name:FENGJI
Middle Name:
Last Name:PIAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21323 NORWALK BLVD APT 50
Mailing Address - Street 2:
Mailing Address - City:HAWAIIAN GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90716-1039
Mailing Address - Country:US
Mailing Address - Phone:562-474-3179
Mailing Address - Fax:
Practice Address - Street 1:21323 NORWALK BLVD APT 50
Practice Address - Street 2:
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-1039
Practice Address - Country:US
Practice Address - Phone:562-474-3179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-09-28
Deactivation Date:2023-09-15
Deactivation Code:
Reactivation Date:2023-09-28
Provider Licenses
StateLicense IDTaxonomies
CA19839171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty