MEDICARE: J. WU MEDICAL CARE INC

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	A70880	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	:	1356386247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J. WU MEDICAL CARE INC

Provider Business Mailing Address
First Line	:	PO BOX 4071
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92863-4071
Country	:	US
Telephone Number	:	562-595-9206
Fax Number	:

Provider Business Practice Location Address
First Line	:	3845 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3505
Country	:	US
Telephone Number	:	562-595-9206
Fax Number	:	562-595-9209

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JACK C WU
Credential	:	MD
Telephone Number	:	562-595-9206

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	07/12/2014

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