Provider Demographics
NPI:1154349959
Name:TANG, WEILIAN S (LAC)
Entity type:Individual
Prefix:
First Name:WEILIAN
Middle Name:S
Last Name:TANG
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:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91802-0847
Mailing Address - Country:US
Mailing Address - Phone:626-679-2047
Mailing Address - Fax:
Practice Address - Street 1:41 N GARFIELD AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3556
Practice Address - Country:US
Practice Address - Phone:626-679-2047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6155171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC6155OtherLICENSE NUMBER