MEDICARE: ELLIN YING-CHUN WU O.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	152WC0802X	Corneal and Contact Management Optometrist	OPT13544	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063660660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLIN YING-CHUN WU O.D.

Provider Business Mailing Address
First Line	:	1085 W EL CAMINO REAL
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-1030
Country	:	US
Telephone Number	:	408-524-5900
Fax Number	:	408-524-5950

Provider Business Practice Location Address
First Line	:	1085 W EL CAMINO REAL
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-1030
Country	:	US
Telephone Number	:	408-524-5900
Fax Number	:	408-524-5950

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

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	08/30/2021

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