Provider Demographics
NPI:1326472176
Name:WU, PEICHING PEGGY
Entity Type:Individual
Prefix:
First Name:PEICHING
Middle Name:PEGGY
Last Name:WU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:P
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21619 PARKVIEW CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1414
Mailing Address - Country:US
Mailing Address - Phone:909-444-3138
Mailing Address - Fax:
Practice Address - Street 1:21619 PARKVIEW CT
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-1414
Practice Address - Country:US
Practice Address - Phone:909-444-3138
Practice Address - Fax:909-444-3138
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12215171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist