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General NPI Number Information
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NPI Number | 1356166060
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Entity Type | Individual
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Provider Name | CONNOR WU PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 501 MARIN ST STE 205
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4266
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Country | US
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Telephone | 818-318-2430
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Fax |
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Provider Business Mailing Address
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Address Line | 18529 CALVERT ST APT 305
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City | TARZANA
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State | CA
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Zip | 91335-7385
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Country | US
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Telephone | 408-637-0614
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 307222
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License Number State | CA
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