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General NPI Number Information
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NPI Number | 1013288463
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Entity Type | Organization
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Legal Business Name | SOCAL THORACIC SURGICAL ASSOCIATES INC
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 260 S LOS ROBLES AVE STE 118
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City | PASADENA
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State | CA
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Zip | 91101-2869
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Country | US
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Telephone | 626-666-5820
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Fax | 626-666-5821
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Provider Business Mailing Address
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Address Line | 260 S LOS ROBLES AVE STE 118
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City | PASADENA
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State | CA
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Zip | 91101-2869
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Country | US
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Telephone | 626-666-5820
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Fax | 626-666-5821
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JAMES T. WU
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Credential | M. D.
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Telephone | 626-666-5820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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