Provider Demographics
NPI:1063641660
Name:WENWU JIN MD PHD INCORPORATED
Entity Type:Organization
Organization Name:WENWU JIN MD PHD INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WENWU
Authorized Official - Middle Name:
Authorized Official - Last Name:JIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-392-9690
Mailing Address - Street 1:929 CLAY ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-1500
Mailing Address - Country:US
Mailing Address - Phone:415-392-9690
Mailing Address - Fax:415-392-9695
Practice Address - Street 1:929 CLAY ST
Practice Address - Street 2:SUITE 505
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-1556
Practice Address - Country:US
Practice Address - Phone:415-392-9690
Practice Address - Fax:415-392-9695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty