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NPI Code Detail

MEDICARE: MR. VIRASENI WU RN NP

MEDICARE: MR. VIRASENI WU RN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse262207CA
2363LP2300XPrimary Care Nurse Practitioner8539CA

General Provider Information

NPI Number : 1487847984
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VIRASENI WU RN NP
Provider Business Mailing Address
First Line : PO BOX 6627
Second Line :
City : ORANGE
State : CA
Zip : 92863-6627
Country : US
Telephone Number : 310-753-2680
Fax Number :
Provider Business Practice Location Address
First Line : 1241 E DYER RD STE 145
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-5694
Country : US
Telephone Number : 888-306-0615
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2007
Last Update Date : 05/21/2015

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