Healthcare Provider Details

I. General information

NPI: 1942730767
Provider Name (Legal Business Name): VICKY WEI LU L. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 E LAS TUNAS DR UNIT 2G
SAN GABRIEL CA
91776-1597
US

IV. Provider business mailing address

5222 DOREEN AVE
TEMPLE CITY CA
91780-3440
US

V. Phone/Fax

Practice location:
  • Phone: 626-321-1940
  • Fax:
Mailing address:
  • Phone: 626-321-1940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC17617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: