Healthcare Provider Details

I. General information

NPI: 1720918113
Provider Name (Legal Business Name): JINZHI WANG
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 E EL CAMINO REAL SPC 242
MOUNTAIN VIEW CA
94040-2707
US

IV. Provider business mailing address

191 E EL CAMINO REAL SPC 242
MOUNTAIN VIEW CA
94040-2707
US

V. Phone/Fax

Practice location:
  • Phone: 650-666-7671
  • Fax:
Mailing address:
  • Phone: 650-666-7671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20656
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: