Healthcare Provider Details

I. General information

NPI: 1154857175
Provider Name (Legal Business Name): JAMES J WU MEDICAL CORPORTAION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 N ORANGE GROVE AVE 200
POMONA CA
91767-3028
US

IV. Provider business mailing address

2130 CRESTA DR
NEWPORT BEACH CA
92660-4610
US

V. Phone/Fax

Practice location:
  • Phone: 909-622-6433
  • Fax:
Mailing address:
  • Phone: 909-945-7201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA119747
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES WU
Title or Position: PRESIDENT
Credential: MD
Phone: 909-945-7201