Healthcare Provider Details

I. General information

NPI: 1609939701
Provider Name (Legal Business Name): ARTHUR J W WU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20833 VALLEY BLVD
WALNUT CA
91789
US

IV. Provider business mailing address

20833 VALLEY BLVD
WALNUT CA
91789
US

V. Phone/Fax

Practice location:
  • Phone: 909-595-7773
  • Fax: 909-595-0256
Mailing address:
  • Phone: 909-595-7773
  • Fax: 909-595-0256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDY035062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: