Provider Demographics
NPI:1639222482
Name:WU, JERRY YOURUI (LAC)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:YOURUI
Last Name:WU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:809 SAN ANTONIO RD STE 10
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4626
Mailing Address - Country:US
Mailing Address - Phone:650-320-9538
Mailing Address - Fax:650-320-8230
Practice Address - Street 1:809 SAN ANTONIO RD STE 10
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4626
Practice Address - Country:US
Practice Address - Phone:650-320-9538
Practice Address - Fax:650-320-8230
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6423171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist