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General NPI Number Information
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NPI Number | 1639925084
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Entity Type | Organization
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Legal Business Name | ORIGIN ACUPUNCTURE AND WELLNESS, PROF CORP
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 2501 E CHAPMAN AVE STE 107
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City | FULLERTON
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State | CA
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Zip | 92831-3135
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Country | US
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Telephone | 469-558-6817
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Fax |
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Provider Business Mailing Address
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Address Line | 2143 DUBLIN LN UNIT 2
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City | DIAMOND BAR
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State | CA
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Zip | 91765-6232
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHUYING WUU
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Credential | LAC
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Telephone | 469-558-6917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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