Provider Demographics
NPI:1043090376
Name:WANG, WEN-JING (LAC)
Entity type:Individual
Prefix:
First Name:WEN-JING
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:WENJIN
Other - Middle Name:WANG
Other - Last Name:CHOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14270 MANGO DR
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2927
Mailing Address - Country:US
Mailing Address - Phone:858-847-8273
Mailing Address - Fax:
Practice Address - Street 1:14270 MANGO DR
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2927
Practice Address - Country:US
Practice Address - Phone:858-847-8273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000130171100000X
TXAC00231171100000X
CAAC3706171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist