MEDICARE: WINSTON WANG L.AC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC14148	CA

General Provider Information

NPI Number	:	1821340217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WINSTON WANG L.AC

Provider Business Mailing Address
First Line	:	22052 LAKELAND AVE
Second Line	:
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-2433
Country	:	US
Telephone Number	:	949-419-5677
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 W CHAPMAN AVE STE 102
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-2648
Country	:	US
Telephone Number	:	818-923-6345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2012
Last Update Date	:	07/21/2022

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