Provider Demographics
NPI:1720483357
Name:WANG, MEI MEI (LAC)
Entity Type:Individual
Prefix:
First Name:MEI MEI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MAY
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 N JACKSON AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1916
Mailing Address - Country:US
Mailing Address - Phone:408-499-8186
Mailing Address - Fax:
Practice Address - Street 1:125 N JACKSON AVE STE 210
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1916
Practice Address - Country:US
Practice Address - Phone:408-499-8186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16217171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist