Provider Demographics
NPI:1235354150
Name:WU, KENG I JAMES (DO)
Entity Type:Individual
Prefix:
First Name:KENG I
Middle Name:JAMES
Last Name:WU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3917 W ORIOLE CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8078
Mailing Address - Country:US
Mailing Address - Phone:626-414-7459
Mailing Address - Fax:626-414-7459
Practice Address - Street 1:1050 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2251
Practice Address - Country:US
Practice Address - Phone:559-684-8703
Practice Address - Fax:559-685-2405
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9811207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine