Healthcare Provider Details

I. General information

NPI: 1154013803
Provider Name (Legal Business Name): MING-WEI WU, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S STATE COLLEGE BLVD
BREA CA
92821-5823
US

IV. Provider business mailing address

3750 S JONES BLVD STE 120
LAS VEGAS NV
89103-2209
US

V. Phone/Fax

Practice location:
  • Phone: 888-434-8880
  • Fax:
Mailing address:
  • Phone: 888-434-8880
  • Fax: 855-434-8880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MING-WEI DANIEL WU
Title or Position: OWNER
Credential:
Phone: 702-434-8880