Healthcare Provider Details

I. General information

NPI: 1689050379
Provider Name (Legal Business Name): WU CHIROPRACTIC CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N STATE COLLEGE BLVD. #B
ANAHEIM CA
92806
US

IV. Provider business mailing address

114 S LONDON CT
ANAHEIM CA
92806
US

V. Phone/Fax

Practice location:
  • Phone: 626-329-8115
  • Fax:
Mailing address:
  • Phone: 626-329-8115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number15337
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32260
License Number StateCA

VIII. Authorized Official

Name: HUNGCHIAO LISA WU
Title or Position: PRESIDENT
Credential: D.C.
Phone: 626-329-8115