Healthcare Provider Details

I. General information

NPI: 1659489268
Provider Name (Legal Business Name): HENRY H WU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 12/14/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 KATELLA AVE STE 320
LOS ALAMITOS CA
90720-3344
US

IV. Provider business mailing address

PO BOX 1868
LOS ALAMITOS CA
90720-1868
US

V. Phone/Fax

Practice location:
  • Phone: 562-598-0200
  • Fax:
Mailing address:
  • Phone: 562-598-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberG84427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: