Provider Demographics
NPI:1881840916
Name:WANG, RUILING (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:RUILING
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5651 N PERSHING AVE
Mailing Address - Street 2:SUITE A-4
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-4947
Mailing Address - Country:US
Mailing Address - Phone:209-477-5230
Mailing Address - Fax:
Practice Address - Street 1:5651 N PERSHING AVE
Practice Address - Street 2:SUITE A-4
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-4947
Practice Address - Country:US
Practice Address - Phone:209-477-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9415171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist