MEDICARE: DAVID WU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	A110885	CA
2	208VP0000X	Pain Medicine Physician	A11085	CA

General Provider Information

NPI Number	:	1013113935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID WU M.D.

Provider Business Mailing Address
First Line	:	1408 CRENSHAW BLVD
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90501-2433
Country	:	US
Telephone Number	:	424-256-7356
Fax Number	:	424-253-0925

Provider Business Practice Location Address
First Line	:	400 CONTINENTAL BLVD # 6144
Second Line	:
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-5076
Country	:	US
Telephone Number	:	310-507-9121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	05/29/2019

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Directions to “ DAVID WU M.D.” Practice Location

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