Provider Demographics
NPI:1033392675
Name:WU, TENG FANG (MACOM)
Entity Type:Individual
Prefix:
First Name:TENG FANG
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:MACOM
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Mailing Address - Street 1:9221 E BASELINE RD
Mailing Address - Street 2:SUITE A109-617
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-8310
Mailing Address - Country:US
Mailing Address - Phone:480-357-3904
Mailing Address - Fax:480-357-4639
Practice Address - Street 1:5501 N ORACLE RD
Practice Address - Street 2:SUITE 145
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3829
Practice Address - Country:US
Practice Address - Phone:520-889-9366
Practice Address - Fax:480-357-4639
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ0448171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist