Provider Demographics
NPI:1922647056
Name:LOU, WENLIN
Entity Type:Individual
Prefix:
First Name:WENLIN
Middle Name:
Last Name:LOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 POMEROY AVE # UNITE73
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5114
Mailing Address - Country:US
Mailing Address - Phone:669-600-9236
Mailing Address - Fax:
Practice Address - Street 1:7337 BOLLINGER RD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-4354
Practice Address - Country:US
Practice Address - Phone:408-645-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18739171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty