Provider Demographics
NPI:1215357223
Name:WU, MELANIE (DO)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44045 MARGARITA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-2729
Mailing Address - Country:US
Mailing Address - Phone:951-462-4624
Mailing Address - Fax:951-462-4625
Practice Address - Street 1:44045 MARGARITA RD STE 106
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2729
Practice Address - Country:US
Practice Address - Phone:951-462-4624
Practice Address - Fax:951-462-4625
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A143852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology