Healthcare Provider Details

I. General information

NPI: 1982233649
Provider Name (Legal Business Name): JONATHAN GENE-LIN WU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2020
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

443 W GARVEY AVE # C-281
MONTEREY PARK CA
91754-7423
US

V. Phone/Fax

Practice location:
  • Phone: 424-306-5600
  • Fax:
Mailing address:
  • Phone: 626-822-7769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036.167239
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A20120
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.167239
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A20120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: