Provider Demographics
NPI:1841494721
Name:WANG, SHU-CHUAN (LAC,OMD)
Entity type:Individual
Prefix:
First Name:SHU-CHUAN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC,OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2293 LIDO CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-6017
Mailing Address - Country:US
Mailing Address - Phone:209-477-1305
Mailing Address - Fax:
Practice Address - Street 1:582 SAN JOSE AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4410
Practice Address - Country:US
Practice Address - Phone:415-806-6653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5181171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist