Provider Demographics
NPI:1871750109
Name:JIANG, XIAO
Entity type:Individual
Prefix:
First Name:XIAO
Middle Name:
Last Name:JIANG
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 1:6022 W PICO BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2673
Mailing Address - Country:US
Mailing Address - Phone:310-989-8668
Mailing Address - Fax:323-939-1736
Practice Address - Street 1:6022 W PICO BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2673
Practice Address - Country:US
Practice Address - Phone:310-989-8668
Practice Address - Fax:323-939-1736
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4280171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist