Healthcare Provider Details

I. General information

NPI: 1134648132
Provider Name (Legal Business Name): KAREN WU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 PLAZA DR LENSCRAFTERS OPTIQUE AT MACY'S
WEST COVINA CA
91790-2803
US

IV. Provider business mailing address

1111 PLAZA DR LENSCRAFTERS OPTIQUE AT MACY'S
WEST COVINA CA
91790-2803
US

V. Phone/Fax

Practice location:
  • Phone: 626-337-7138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT33732-TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: