MEDICARE: DR. KANYANG WU PHD, L.AC.

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	7102	CA

General Provider Information

NPI Number	:	1932220050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KANYANG WU PHD, L.AC.

Provider Business Mailing Address
First Line	:	17595 ALMAHURST ST
Second Line	:	STE 222
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91748-1799
Country	:	US
Telephone Number	:	626-839-9988
Fax Number	:	626-839-9988

Provider Business Practice Location Address
First Line	:	17595 ALMAHURST ST
Second Line	:	STE 222
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91748-1799
Country	:	US
Telephone Number	:	626-839-9988
Fax Number	:	626-839-9988

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/08/2007

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