Provider Demographics
NPI:1548468192
Name:LI DE WANG, FENG LING (ACUPUNCTURIST)
Entity type:Individual
Prefix:DR
First Name:FENG LING
Middle Name:
Last Name:LI DE 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 1:3057 S. HIGUERA ST. SPC. 40
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401
Mailing Address - Country:US
Mailing Address - Phone:805-550-9366
Mailing Address - Fax:805-543-4403
Practice Address - Street 1:1422 MONTEREY ST. C-102
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-550-9366
Practice Address - Fax:805-543-5106
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9597171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist