Provider Demographics
NPI:1922435197
Name:WU, CHIEN CHIH
Entity Type:Individual
Prefix:MR
First Name:CHIEN CHIH
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JACK
Other - Middle Name:
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1075 SPACE PARK WAY
Mailing Address - Street 2:SPC 281
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-1416
Mailing Address - Country:US
Mailing Address - Phone:650-399-6968
Mailing Address - Fax:
Practice Address - Street 1:1075 SPACE PARK WAY
Practice Address - Street 2:SPC 281
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1416
Practice Address - Country:US
Practice Address - Phone:650-399-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15674171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA15674OtherACUPUNCTURIST