Provider Demographics
NPI:1326447970
Name:WANG, WEIZHONG
Entity Type:Individual
Prefix:
First Name:WEIZHONG
Middle Name:
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 1:300 S ATLANTIC BLVD
Mailing Address - Street 2:UNIT 101
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-3250
Mailing Address - Country:US
Mailing Address - Phone:626-780-0770
Mailing Address - Fax:
Practice Address - Street 1:300 S ATLANTIC BLVD
Practice Address - Street 2:UNIT 101
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-3250
Practice Address - Country:US
Practice Address - Phone:626-780-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9956171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist