Provider Demographics
NPI:1518222025
Name:WU, WENDY WEN-LU (LAC)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:WEN-LU
Last Name:WU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:WEN-LU
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:PO BOX 3238
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-1238
Mailing Address - Country:US
Mailing Address - Phone:424-392-5085
Mailing Address - Fax:
Practice Address - Street 1:2243 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-5302
Practice Address - Country:US
Practice Address - Phone:424-392-5085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8596171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist