MEDICARE: DR. HEIDI H. 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	207R00000X	Internal Medicine Physician	A61786	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
2	95-4867055	OTHER	CA	BLUE CROSS
3	00A617860	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1326042136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEIDI H. WU M.D.

Provider Business Mailing Address
First Line	:	50 N LA CIENEGA BLVD
Second Line	:	SUITE 320
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2227
Country	:	US
Telephone Number	:	310-659-9950
Fax Number	:	310-659-9957

Provider Business Practice Location Address
First Line	:	50 N. LA CIENEGA BLVD.
Second Line	:	STE 320
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211
Country	:	US
Telephone Number	:	310-659-9950
Fax Number	:	310-659-9957

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	06/13/2008

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