Healthcare Provider Details

I. General information

NPI: 1235200825
Provider Name (Legal Business Name): MICHAEL WU, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 POINTE DR SUITE 305
BREA CA
92821-3651
US

IV. Provider business mailing address

3 POINTE DR SUITE 305
BREA CA
92821-3651
US

V. Phone/Fax

Practice location:
  • Phone: 714-276-2930
  • Fax: 714-256-9013
Mailing address:
  • Phone: 714-276-2930
  • Fax: 714-256-9013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA81748
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL C. WU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-276-2930