Healthcare Provider Details

I. General information

NPI: 1528786043
Provider Name (Legal Business Name): DORIAN WU FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W 5TH ST
HANFORD CA
93230-5029
US

IV. Provider business mailing address

9001 STOCKDALE HWY DEPT OF
BAKERSFIELD CA
93311-1022
US

V. Phone/Fax

Practice location:
  • Phone: 877-960-3426
  • Fax:
Mailing address:
  • Phone: 661-654-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95030374
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: