Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A91181 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 218786-1 | NY |
NPI | 1720070113 |
---|---|
Provider Name | Dr. James C Wu |
First Address | Daly City, CA 94015-2228 |
Second Address | Daly City, CA 94015-2228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 23/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I17377 | (02) |