Provider Demographics
NPI:1295596633
Name:WANG ACUPUNCTURE PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:WANG ACUPUNCTURE PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZHIMIAO
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-832-1962
Mailing Address - Street 1:1518 LAGO ST APT 105
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2060
Mailing Address - Country:US
Mailing Address - Phone:650-832-1962
Mailing Address - Fax:
Practice Address - Street 1:370 BRIDGE PKWY STE 2A
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-1036
Practice Address - Country:US
Practice Address - Phone:650-832-1962
Practice Address - Fax:650-508-9788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty