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General NPI Number Information
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NPI Number | 1942568928
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Entity Type | Individual
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Provider Name | YUEN RYAN WU D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 925 W 34TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90089-2804
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Country | US
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Telephone | 714-608-0780
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Fax |
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Provider Business Mailing Address
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Address Line | 5538 TUCKEROO WAY
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City | FAIR OAKS
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State | CA
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Zip | 95628-3893
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Country | US
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Telephone |
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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 | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 64456
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License Number State | CA
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