Provider Demographics
NPI:1194828707
Name:WU, PELEN TAMMY (MD)
Entity Type:Individual
Prefix:DR
First Name:PELEN
Middle Name:TAMMY
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3 ALTARINDA RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2601
Mailing Address - Country:US
Mailing Address - Phone:925-254-9500
Mailing Address - Fax:925-254-9505
Practice Address - Street 1:3 ALTARINDA RD STE 300
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2601
Practice Address - Country:US
Practice Address - Phone:925-254-9500
Practice Address - Fax:925-254-9505
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA75735208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H88182Medicare UPIN