Provider Demographics
NPI:1366505810
Name:WANG, CHRISTOPHER JIU LONG (LAC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JIU LONG
Last Name:WANG
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:25381 ALICIA PKWY
Mailing Address - Street 2:SUITE T
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-951-3711
Mailing Address - Fax:949-830-7767
Practice Address - Street 1:25381 ALICIA PKWY
Practice Address - Street 2:SUITE T
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-951-3711
Practice Address - Fax:949-830-7767
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC5373171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist