Healthcare Provider Details

I. General information

NPI: 1275612640
Provider Name (Legal Business Name): HEN SHIN WU MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 HOSPITAL DR #241
MOUNTAIN VIEW CA
94040
US

IV. Provider business mailing address

2485 HOSPITAL DR #241
MOUNTAIN VIEW CA
94040
US

V. Phone/Fax

Practice location:
  • Phone: 650-988-7666
  • Fax:
Mailing address:
  • Phone: 650-988-7666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA311890
License Number StateCA

VIII. Authorized Official

Name: HEN SHIN WU
Title or Position: PRESIDENT
Credential: MD
Phone: 650-988-7666