Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 34583 | CA |
NPI | 1003458167 |
---|---|
Provider Name | Gene Kou Xiong |
First Address | Atwater, CA 95301-5308 |
Second Address | Tulare, CA 93274-2344 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2019 |
Last Update Date | 10/10/2019 |