Provider Demographics
NPI:1043536196
Name:WANG, PEI SHENG
Entity Type:Individual
Prefix:
First Name:PEI
Middle Name:SHENG
Last Name:WANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 PLYMOUTH WAY
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-2729
Mailing Address - Country:US
Mailing Address - Phone:415-652-1981
Mailing Address - Fax:650-588-9350
Practice Address - Street 1:2640 PLYMOUTH WAY
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-2729
Practice Address - Country:US
Practice Address - Phone:415-652-1981
Practice Address - Fax:650-588-9350
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA13491171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist