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NPI 1912044421

NPI 1912044421 : HENRY JIANGUO WANG L.AC : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1912044421
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    Entity Type          |    Individual 
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    Provider Name        |    HENRY JIANGUO WANG L.AC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/31/2007
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    Last Update Date     |    07/26/2018
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Provider Practice Location Address
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    Address Line         |    4827 GEARY BLVD. 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94118
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    Country              |    US
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    Telephone            |    415-387-7808
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    Fax                  |    415-795-4827
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Provider Business Mailing Address
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    Address Line         |    420 5TH AVE. 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94118
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    Country              |    US
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    Telephone            |    415-387-7808
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    Fax                  |    415-795-4827
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    AC10870
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    License Number State |    CA
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