Provider Demographics
NPI:1073605580
Name:WU, KE (MD)
Entity Type:Individual
Prefix:
First Name:KE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 COYLE AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0306
Mailing Address - Country:US
Mailing Address - Phone:916-537-5079
Mailing Address - Fax:
Practice Address - Street 1:3160 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5219
Practice Address - Country:US
Practice Address - Phone:916-733-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87671208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000810611046OtherPHCS
CA2240124OtherFIRST HEALTH
CA106122OtherHEALTH NET
CA236628OtherINTERPLAN
CAA87671OtherBLUE CROSS
CA2615163OtherUNITED HEALTHCARE
CA1855785OtherGREAT WEST
CA7851353OtherCIGNA
CA90143498OtherPACIFICARE
CAMCMG346000OtherWESTERN HEALTH ADVANTAGE
CA7779623OtherAETNA
CA000810611046OtherPHCS
CA2615163OtherUNITED HEALTHCARE