Healthcare Provider Details

I. General information

NPI: 1174058341
Provider Name (Legal Business Name): YI-CHIA WU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W SAN BERNARDINO RD STE B
COVINA CA
91722
US

IV. Provider business mailing address

500 W SAN BERNARDINO RD STE B
COVINA CA
91722
US

V. Phone/Fax

Practice location:
  • Phone: 626-960-2326
  • Fax:
Mailing address:
  • Phone: 626-960-2326
  • Fax: 626-960-9796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA187617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: