Provider Demographics
NPI:1053777912
Name:LIN WU DBA OC HEALTH ACUPUNCTURE
Entity type:Organization
Organization Name:LIN WU DBA OC HEALTH ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:949-228-8028
Mailing Address - Street 1:740 EL CAMINO REAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-4369
Mailing Address - Country:US
Mailing Address - Phone:949-228-8028
Mailing Address - Fax:949-438-0559
Practice Address - Street 1:740 EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-4369
Practice Address - Country:US
Practice Address - Phone:949-228-8028
Practice Address - Fax:949-438-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10814261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1205123767OtherINDIVIDUAL