MEDICARE: YI-TING WU PA-C

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	363A00000X	Physician Assistant	PA65588	CA

General Provider Information

NPI Number	:	1659016152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YI-TING WU PA-C

Provider Business Mailing Address
First Line	:	1510 SAN PABLO ST STE 415
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5403
Country	:	US
Telephone Number	:	323-442-7920
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 SAN PABLO ST STE 415
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5403
Country	:	US
Telephone Number	:	323-442-7920
Fax Number	:

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

Provider Enumeration Date	:	04/29/2022
Last Update Date	:	09/15/2025

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Directions to “ YI-TING WU PA-C” Practice Location

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