Provider Demographics
NPI:1083872824
Name:WANG, BUER (LAC)
Entity Type:Individual
Prefix:MS
First Name:BUER
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1091 INDUSTRIAL RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-4118
Mailing Address - Country:US
Mailing Address - Phone:650-637-1680
Mailing Address - Fax:
Practice Address - Street 1:1091 INDUSTRIAL RD STE 120
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-4118
Practice Address - Country:US
Practice Address - Phone:650-637-1680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12497171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist