Provider Demographics
NPI:1639663875
Name:WU, STANLEY (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6034 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2026
Mailing Address - Country:US
Mailing Address - Phone:510-898-8800
Mailing Address - Fax:
Practice Address - Street 1:2071 ANTIOCH CT STE 201
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2955
Practice Address - Country:US
Practice Address - Phone:510-519-7495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist