Healthcare Provider Details

I. General information

NPI: 1316073042
Provider Name (Legal Business Name): LI-MING CHEN WU PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY LI-MING WU

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 CALIFORNIA DR STE 120B
MILLBRAE CA
94030-3118
US

IV. Provider business mailing address

1560 ALBEMARLE WAY
BURLINGAME CA
94010-4658
US

V. Phone/Fax

Practice location:
  • Phone: 650-759-8885
  • Fax:
Mailing address:
  • Phone: 650-697-7728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number8697
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: