Provider Demographics
NPI:1215028444
Name:WU, GUOQI (LAC)
Entity Type:Individual
Prefix:
First Name:GUOQI
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 W VALLEY BLVD
Mailing Address - Street 2:# 204
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-2438
Mailing Address - Country:US
Mailing Address - Phone:626-679-1621
Mailing Address - Fax:626-299-1998
Practice Address - Street 1:1227 W VALLEY BLVD
Practice Address - Street 2:# 204
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-2438
Practice Address - Country:US
Practice Address - Phone:626-679-1621
Practice Address - Fax:626-299-1998
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9827171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC9827OtherLICENSE NUMBER