Healthcare Provider Details

I. General information

NPI: 1811819725
Provider Name (Legal Business Name): BRYAN YANG WU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12602 VENTURA BLVD
STUDIO CITY CA
91604-2414
US

IV. Provider business mailing address

10504 MILDRED ST
EL MONTE CA
91733-1344
US

V. Phone/Fax

Practice location:
  • Phone: 818-762-2055
  • Fax:
Mailing address:
  • Phone: 626-297-9348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92547
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: