Healthcare Provider Details

I. General information

NPI: 1265538912
Provider Name (Legal Business Name): ALLAN YANG WU M.D., C.T.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 03/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 W COLE BLVD
CALEXICO CA
92231-9722
US

IV. Provider business mailing address

233 W COLE BLVD SUITE A
CALEXICO CA
92231-9722
US

V. Phone/Fax

Practice location:
  • Phone: 760-344-9951
  • Fax: 760-344-1629
Mailing address:
  • Phone: 760-357-2020
  • Fax: 760-357-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA67036
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number01057730
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA67036
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number01057730
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number01057720
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: