Individual
FUQUAN GAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
42137 1/2 BIG BEAR BLVD #I, BIG BEAR LAKE, CA 92315
(909) 666-1107
Mailing address
505 W BENCAMP ST APT E, SAN GABRIEL, CA 91776-3747
(626) 620-7771
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
BUS-00672
CA
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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