=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700901410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RONG WUU L.AC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 433 ESTUDILLO AVE STE 209
-----------------------------------------------------
City | SAN LEANDRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94577-4915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-357-3690
-----------------------------------------------------
Fax | 510-357-3790
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2100 ARROWHEAD DR
-----------------------------------------------------
City | OAKLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94611-1558
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-309-7806
-----------------------------------------------------
Fax | 510-357-3790
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC8394
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------