MEDICARE: DR. STANLEY WU DACM, LAC

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

General Provider Information

NPI Number	:	1639663875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY WU DACM, LAC

Provider Business Mailing Address
First Line	:	6034 VALLEY VIEW RD
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-2026
Country	:	US
Telephone Number	:	510-898-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2071 ANTIOCH CT STE 201
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-2955
Country	:	US
Telephone Number	:	510-519-7495
Fax Number	:

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

Provider Enumeration Date	:	06/20/2018
Last Update Date	:	06/20/2018

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