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General NPI Number Information
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NPI Number | 1144463761
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Entity Type | Individual
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Provider Name | JENNIFER LEE WU MD
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Gender | Female
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3033 BRISTOL ST UNIT 123
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City | COSTA MESA
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State | CA
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Zip | 92626-3091
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Country | US
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Telephone | 949-208-9090
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Fax | 949-546-1141
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Provider Business Mailing Address
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Address Line | 3033 BRISTOL ST UNIT 123
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City | COSTA MESA
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State | CA
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Zip | 92626-3091
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Country | US
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Telephone | 949-208-9090
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Fax | 949-546-1141
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 30583
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A117309
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License Number State | CA
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