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General NPI Number Information
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NPI Number | 1356550636
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Entity Type | Individual
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Provider Name | SHUFONG ANDREW WU M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 9353 IMPERIAL HWY DEPARTMENT OF RADIOLOGY
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City | DOWNEY
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State | CA
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Zip | 90242-2812
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Country | US
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Telephone | 562-657-7240
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Fax |
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Provider Business Mailing Address
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Address Line | 1651 S OAK KNOLL AVE
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City | SAN MARINO
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State | CA
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Zip | 91108-1775
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Country | US
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Telephone | 626-799-7740
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R-7688
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A106166
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License Number State | CA
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