Provider Demographics
NPI:1043665441
Name:WU, SAMANTHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1700 N ROSE AVE STE 430
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-7657
Mailing Address - Country:US
Mailing Address - Phone:805-485-8722
Mailing Address - Fax:805-485-9311
Practice Address - Street 1:1700 N ROSE AVE STE 430
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7657
Practice Address - Country:US
Practice Address - Phone:805-485-8722
Practice Address - Fax:805-485-9311
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA163393208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery