Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | A89822 | CA |
NPI | 1245421015 |
---|---|
Provider Name | Dr. Patty Wu |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 02/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1902846306 | GROUP NPI (01) | CA |
A89822 | (02) | CA |
GR0100430 | GROUP MEDI-CAL (01) | CA |
W18762 | GROUP MEDICARE (01) | CA |