Provider Demographics
NPI:1528232584
Name:TIEN, WEI-I (L AC)
Entity Type:Individual
Prefix:MR
First Name:WEI-I
Middle Name:
Last Name:TIEN
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:MR
Other - First Name:LAWRENCE
Other - Middle Name:WEI-I
Other - Last Name:TIEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:L AC
Mailing Address - Street 1:2311 S EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2213
Mailing Address - Country:US
Mailing Address - Phone:650-921-8681
Mailing Address - Fax:650-588-7037
Practice Address - Street 1:2311 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2213
Practice Address - Country:US
Practice Address - Phone:650-921-8681
Practice Address - Fax:650-588-7037
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-21
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12381171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist