Healthcare Provider Details
I. General information
NPI: 1710059423
Provider Name (Legal Business Name): WANYU HUANG L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4330 BARRANCA PKWY STE. 245
IRVINE CA
92604-4755
US
IV. Provider business mailing address
4330 BARRANCA PKWY STE. 245
IRVINE CA
92604-4755
US
V. Phone/Fax
- Phone: 949-857-2388
- Fax: 949-857-0198
- Phone: 949-857-2388
- Fax: 949-857-0198
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC11146 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: