Provider Demographics
NPI:1508190455
Name:WU, WENWEI (DAOM)
Entity Type:Individual
Prefix:
First Name:WENWEI
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2081 FOREST AVE, SUITE 1
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4841
Mailing Address - Country:US
Mailing Address - Phone:408-480-2860
Mailing Address - Fax:408-998-1984
Practice Address - Street 1:2081 FOREST AVE, SUITE 1
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4841
Practice Address - Country:US
Practice Address - Phone:408-480-2860
Practice Address - Fax:408-998-1984
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8490171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist