MEDICARE: JULIE WU

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	104100000X	Social Worker	63987	CA
2	207L00000X	Anesthesiology Physician	76316	CA
3	1041C0700X	Clinical Social Worker	76316	CA

General Provider Information

NPI Number	:	1679963276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE WU

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	757 WESTWOOD PLZ STE 3325
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-2732
Country	:	US
Telephone Number	:	310-825-9111
Fax Number	:

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

Provider Enumeration Date	:	02/03/2015
Last Update Date	:	09/11/2023

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Directions to “ JULIE WU ” Practice Location

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