Provider Demographics
NPI:1013246263
Name:WANG, CHUNG-PO PETER (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:CHUNG-PO
Middle Name:PETER
Last Name:WANG
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9939 GARVEY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-4712
Mailing Address - Country:US
Mailing Address - Phone:626-442-0800
Mailing Address - Fax:626-442-3800
Practice Address - Street 1:9939 GARVEY AVE STE A
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-4712
Practice Address - Country:US
Practice Address - Phone:626-442-0800
Practice Address - Fax:626-442-3800
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13178171100000X
CADC 31223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist