Provider Demographics
NPI:1720095540
Name:WANG, LIN YING (OMD LAC)
Entity Type:Individual
Prefix:MRS
First Name:LIN
Middle Name:YING
Last Name:WANG
Suffix:
Gender:F
Credentials:OMD LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 CASTRO STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041
Mailing Address - Country:US
Mailing Address - Phone:650-961-1688
Mailing Address - Fax:650-961-1688
Practice Address - Street 1:795 CASTRO STREET
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041
Practice Address - Country:US
Practice Address - Phone:650-961-1688
Practice Address - Fax:650-961-1688
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5636171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist