Provider Demographics
NPI:1629403985
Name:WEILIAN TANG LAC INC
Entity Type:Organization
Organization Name:WEILIAN TANG LAC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.AC
Authorized Official - Prefix:
Authorized Official - First Name:WEILIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-679-2047
Mailing Address - Street 1:10 W. BAY STATE STREET, #847
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91802-0847
Mailing Address - Country:US
Mailing Address - Phone:626-679-2047
Mailing Address - Fax:
Practice Address - Street 1:41 N GARFIELD AVE STE 103
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-7501
Practice Address - Country:US
Practice Address - Phone:626-679-2047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6155171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty