Provider Demographics
NPI:1922139674
Name:FU, YUAN ZHI (LIC ACP)
Entity Type:Individual
Prefix:DR
First Name:YUAN
Middle Name:ZHI
Last Name:FU
Suffix:
Gender:F
Credentials:LIC ACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 MANCHESTER AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4938
Mailing Address - Country:US
Mailing Address - Phone:760-452-0766
Mailing Address - Fax:
Practice Address - Street 1:4401 MANCHESTER AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4938
Practice Address - Country:US
Practice Address - Phone:760-452-0766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACY3024171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist