Healthcare Provider Details

I. General information

NPI: 1629598529
Provider Name (Legal Business Name): WENDY UYEN VU REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WEST CARSON STREET
TORRANCE CA
90509-2004
US

IV. Provider business mailing address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-5699
  • Fax:
Mailing address:
  • Phone: 310-222-5699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number615950
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number615950
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: