Healthcare Provider Details

I. General information

NPI: 1649884552
Provider Name (Legal Business Name): KARMEN WU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 S 1ST ST STE D
ALHAMBRA CA
91801-3790
US

IV. Provider business mailing address

3131 S 8TH AVE
ARCADIA CA
91006-5720
US

V. Phone/Fax

Practice location:
  • Phone: 833-476-7377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: