Provider Demographics
NPI:1518056449
Name:WANG, DAVID C (LAC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:WANG
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:12903 ALCOSTA BLVD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1335
Mailing Address - Country:US
Mailing Address - Phone:925-866-8560
Mailing Address - Fax:925-866-8577
Practice Address - Street 1:12903 ALCOSTA BLVD
Practice Address - Street 2:SUITE 2D
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1335
Practice Address - Country:US
Practice Address - Phone:925-866-8560
Practice Address - Fax:925-866-8577
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC-268171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist