Provider Demographics
NPI:1194898684
Name:MAO, WENMING (LAC)
Entity type:Individual
Prefix:MR
First Name:WENMING
Middle Name:
Last Name:MAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 ABORN RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1582
Mailing Address - Country:US
Mailing Address - Phone:408-221-1886
Mailing Address - Fax:408-532-9280
Practice Address - Street 1:1952 ABORN RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1582
Practice Address - Country:US
Practice Address - Phone:408-221-1886
Practice Address - Fax:408-532-9280
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6693171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist