Provider Demographics
NPI:1447331970
Name:GAO, QUANFU
Entity type:Individual
Prefix:
First Name:QUANFU
Middle Name:
Last Name:GAO
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 1:616 N GARFIELD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1153
Mailing Address - Country:US
Mailing Address - Phone:626-288-0369
Mailing Address - Fax:626-288-0369
Practice Address - Street 1:616 N GARFIELD AVE STE 201
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1153
Practice Address - Country:US
Practice Address - Phone:626-288-0369
Practice Address - Fax:626-288-0369
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC6710171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist