Healthcare Provider Details

I. General information

NPI: 1194890137
Provider Name (Legal Business Name): WENYING ZHU LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2147 MOWRY AVE SUITE A4
FREMONT CA
94538-1724
US

IV. Provider business mailing address

2147 MOWRY AVE SUITE A4
FREMONT CA
94538-1724
US

V. Phone/Fax

Practice location:
  • Phone: 510-494-9788
  • Fax:
Mailing address:
  • Phone: 510-494-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number6416
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: