Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 256605 | MA |
N | 111NI0900X | Internist | 256605 | MA |
Y | 207X00000X | Orthopaedic Surgeon | A156777 | CA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | A156777 | CA |
NPI | 1023457009 |
---|---|
Provider Name | Dr. I-Kung Wu |
First Address | San Francisco, CA 94143-2202 |
Second Address | San Francisco, CA 94143-2202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2013 |
Last Update Date | 06/11/2018 |