1790930683 NPI number — WALNUT NATURAL HEALTH CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790930683 NPI number — WALNUT NATURAL HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WALNUT NATURAL HEALTH CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WU CHIROPRACTIC CORPORATION
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790930683
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18710 AMAR RD
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
WALNUT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91789-4571
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-839-8578
Provider Business Mailing Address Fax Number:
626-839-7001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18710 AMAR RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
WALNUT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91789-4571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-839-8578
Provider Business Practice Location Address Fax Number:
626-839-7001
Provider Enumeration Date:
11/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WU
Authorized Official First Name:
MANLI
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
626-839-8578

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC30187 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 171100000X , with the licence number: AC9113 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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