Provider Demographics
NPI:1942524392
Name:REN, WENLIN
Entity Type:Individual
Prefix:
First Name:WENLIN
Middle Name:
Last Name:REN
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 1:9942 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4009
Mailing Address - Country:US
Mailing Address - Phone:562-861-6684
Mailing Address - Fax:562-861-0241
Practice Address - Street 1:9942 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4009
Practice Address - Country:US
Practice Address - Phone:562-861-6684
Practice Address - Fax:562-861-0241
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7646171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist