Provider Demographics
NPI:1578125621
Name:FU, RONGPIN (LAC)
Entity Type:Individual
Prefix:
First Name:RONGPIN
Middle Name:
Last Name:FU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17028 DOUBLEGROVE ST
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-1508
Mailing Address - Country:US
Mailing Address - Phone:626-322-4553
Mailing Address - Fax:
Practice Address - Street 1:285 N EL CAMINO REAL STE 205
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5385
Practice Address - Country:US
Practice Address - Phone:760-230-2490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18012171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty