Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | A110885 | CA |
NPI | 1013113935 |
---|---|
Provider Name | David Wu |
First Address | Torrance, CA 90501-2433 |
Second Address | El Segundo, CA 90245-5076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 29/05/2019 |