Healthcare Provider Details

I. General information

NPI: 1073605580
Provider Name (Legal Business Name): KE WU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 FOLSOM BLVD
SACRAMENTO CA
95816-5219
US

IV. Provider business mailing address

6501 COYLE AVE
CARMICHAEL CA
95608-0306
US

V. Phone/Fax

Practice location:
  • Phone: 916-733-3333
  • Fax:
Mailing address:
  • Phone: 916-537-5079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA87671
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: