Healthcare Provider Details

I. General information

NPI: 1154493682
Provider Name (Legal Business Name): WEIGUO FU O.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 SUTTER ST STE 515
SAN FRANCISCO CA
94108-4318
US

IV. Provider business mailing address

391 SUTTER ST STE 515
SAN FRANCISCO CA
94108-4318
US

V. Phone/Fax

Practice location:
  • Phone: 415-788-2298
  • Fax: 415-759-8957
Mailing address:
  • Phone: 415-788-2298
  • Fax: 415-759-8957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberLAC7510
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: