Provider Demographics
NPI:1710059423
Name:HUANG, WANYU (LAC)
Entity Type:Individual
Prefix:
First Name:WANYU
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:WAN-YU
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:4330 BARRANCA PKWY
Mailing Address - Street 2:STE. 245
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4755
Mailing Address - Country:US
Mailing Address - Phone:949-857-2388
Mailing Address - Fax:949-857-0198
Practice Address - Street 1:4330 BARRANCA PKWY
Practice Address - Street 2:STE. 245
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4755
Practice Address - Country:US
Practice Address - Phone:949-857-2388
Practice Address - Fax:949-857-0198
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11146171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist