Provider Demographics
NPI:1457614711
Name:WU, HUNGCHIAO LISA (DC)
Entity Type:Individual
Prefix:DR
First Name:HUNGCHIAO
Middle Name:LISA
Last Name:WU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N STATE COLLEGE BLVD
Mailing Address - Street 2:SUITE #B
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-2913
Mailing Address - Country:US
Mailing Address - Phone:714-340-7890
Mailing Address - Fax:714-340-7891
Practice Address - Street 1:215 N STATE COLLEGE BLVD
Practice Address - Street 2:SUITE #B
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-2913
Practice Address - Country:US
Practice Address - Phone:714-340-7890
Practice Address - Fax:714-340-7891
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor