Provider Demographics
NPI:1245400621
Name:WANG, LUPING (LAC)
Entity type:Individual
Prefix:
First Name:LUPING
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6989 GLASGOW AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-6370
Mailing Address - Country:US
Mailing Address - Phone:909-888-6326
Mailing Address - Fax:909-888-6156
Practice Address - Street 1:1558 N WATERMAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-5133
Practice Address - Country:US
Practice Address - Phone:909-888-6326
Practice Address - Fax:909-888-6156
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC7545171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist