Healthcare Provider Details

I. General information

NPI: 1396429437
Provider Name (Legal Business Name): WENTING ZHAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W EL CAMINO REAL STE 121
SUNNYVALE CA
94087-1057
US

IV. Provider business mailing address

443 KENT DR
MOUNTAIN VIEW CA
94043-5280
US

V. Phone/Fax

Practice location:
  • Phone: 408-962-0275
  • Fax:
Mailing address:
  • Phone: 312-804-0388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC19623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: