Healthcare Provider Details

I. General information

NPI: 1023015484
Provider Name (Legal Business Name): DAVID W WU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LA CASA VIA STE 204
WALNUT CREEK CA
94598-3007
US

IV. Provider business mailing address

120 LA CASA VIA STE 204
WALNUT CREEK CA
94598-3007
US

V. Phone/Fax

Practice location:
  • Phone: 925-210-1050
  • Fax: 925-210-1082
Mailing address:
  • Phone: 925-210-1050
  • Fax: 925-210-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA83347
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: