Healthcare Provider Details

I. General information

NPI: 1831337872
Provider Name (Legal Business Name): WU MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2009
Last Update Date: 01/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3156 VISTA WAY 405
OCEANSIDE CA
92056-3622
US

IV. Provider business mailing address

28475 PLYMOUTH WAY
TEMECULA CA
92591-3544
US

V. Phone/Fax

Practice location:
  • Phone: 760-439-6581
  • Fax: 760-439-6585
Mailing address:
  • Phone: 760-439-6581
  • Fax: 760-439-6585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN C. WU
Title or Position: ADMINISTRATOR
Credential: M.D.
Phone: 760-439-6581