Provider Demographics
NPI:1104085836
Name:SHUE, JIA-LING (ACUPUNCTURE)
Entity type:Individual
Prefix:MR
First Name:JIA-LING
Middle Name:
Last Name:SHUE
Suffix:
Gender:M
Credentials:ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 HONOLULU AVE
Mailing Address - Street 2:175
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1853
Mailing Address - Country:US
Mailing Address - Phone:818-633-2668
Mailing Address - Fax:
Practice Address - Street 1:2520 HONOLULU AVE
Practice Address - Street 2:175
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1853
Practice Address - Country:US
Practice Address - Phone:818-633-2668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4724171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist