Healthcare Provider Details

I. General information

NPI: 1649244146
Provider Name (Legal Business Name): YIH SHIYNG WU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RICK WU M.D.

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7872 WALKER ST #100
LA PALMA CA
90623-1796
US

IV. Provider business mailing address

7872 WALKER ST #100
LA PALMA CA
90623-1796
US

V. Phone/Fax

Practice location:
  • Phone: 714-522-4009
  • Fax:
Mailing address:
  • Phone: 714-522-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA32143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: