Provider Demographics
NPI:1578644902
Name:WU, MANLI (DC LAC)
Entity Type:Individual
Prefix:MRS
First Name:MANLI
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18710 AMAR RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4571
Mailing Address - Country:US
Mailing Address - Phone:626-839-8578
Mailing Address - Fax:626-839-7001
Practice Address - Street 1:18710 AMAR RD
Practice Address - Street 2:SUITE C
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-4571
Practice Address - Country:US
Practice Address - Phone:626-839-8578
Practice Address - Fax:626-839-7001
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30187111N00000X
CAAC9113171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist