Provider Demographics
NPI:1174554497
Name:WANG, SHING CHIA (ACUPUNCTURIST)
Entity type:Individual
Prefix:MS
First Name:SHING
Middle Name:CHIA
Last Name:WANG
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5814 TEMPLE CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2112
Mailing Address - Country:US
Mailing Address - Phone:626-285-1181
Mailing Address - Fax:626-285-1131
Practice Address - Street 1:5814 TEMPLE CITY BLVD
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-2112
Practice Address - Country:US
Practice Address - Phone:626-285-1181
Practice Address - Fax:626-285-1131
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 4340171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC 0043400Medicaid
CACA 0043400OtherBLUE SHIELD OF CALIFORNIA