Provider Demographics
NPI:1205200284
Name:WU, WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 GARNET AVE # 490
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3352
Mailing Address - Country:US
Mailing Address - Phone:760-443-7112
Mailing Address - Fax:
Practice Address - Street 1:1804 GARNET AVE # 490
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3352
Practice Address - Country:US
Practice Address - Phone:760-443-7112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor