Provider Demographics
NPI:1235335878
Name:WU, CINDY J (OD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:J
Last Name:WU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W 9TH ST APT 1101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-4334
Mailing Address - Country:US
Mailing Address - Phone:626-226-6695
Mailing Address - Fax:
Practice Address - Street 1:2032 MARENGO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1319
Practice Address - Country:US
Practice Address - Phone:323-987-1040
Practice Address - Fax:323-221-4528
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13183T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOP13183Medicare PIN