Healthcare Provider Details

I. General information

NPI: 1003798380
Provider Name (Legal Business Name): DARRELL WU MD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 AVOCADO AVE
EL CAJON CA
92020-4604
US

IV. Provider business mailing address

13382 GREENSTONE CT
SAN DIEGO CA
92131-4242
US

V. Phone/Fax

Practice location:
  • Phone: 619-823-3146
  • Fax: 619-554-8500
Mailing address:
  • Phone: 713-591-7007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DARRELL WU
Title or Position: PRESIDENT
Credential: MD
Phone: 713-591-7001