Provider Demographics
NPI:1366863391
Name:JI, FEI SR (ACUPUNCTURIST)
Entity type:Individual
Prefix:MR
First Name:FEI
Middle Name:
Last Name:JI
Suffix:SR
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21076 SANDPIPER ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2050
Mailing Address - Country:US
Mailing Address - Phone:626-922-1855
Mailing Address - Fax:626-922-1855
Practice Address - Street 1:21076 SANDPIPER ST
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-2050
Practice Address - Country:US
Practice Address - Phone:626-922-1855
Practice Address - Fax:626-922-1855
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15638171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC15683OtherACUPUNCTURIST