Healthcare Provider Details

I. General information

NPI: 1841079985
Provider Name (Legal Business Name): DIANA WU AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIMI WU

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 CALIFORNIA AVE STE 100
BAKERSFIELD CA
93309-0707
US

IV. Provider business mailing address

5100 CALIFORNIA AVE STE 100
BAKERSFIELD CA
93309-0707
US

V. Phone/Fax

Practice location:
  • Phone: 661-637-1100
  • Fax:
Mailing address:
  • Phone: 909-551-9175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3821
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: