MEDICARE: WEI LOU L.A.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC 16213	CA

General Provider Information

NPI Number	:	1558754440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WEI LOU L.A.C

Provider Business Mailing Address
First Line	:	341 CASTRO ST STE D
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94041-1296
Country	:	US
Telephone Number	:	415-423-4462
Fax Number	:	408-414-7732

Provider Business Practice Location Address
First Line	:	341 CASTRO ST STE D
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94041-1296
Country	:	US
Telephone Number	:	408-660-5403
Fax Number	:	408-414-7732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2015
Last Update Date	:	06/04/2015

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