Provider Demographics
NPI:1336331289
Name:WU, JEFFREY KAI (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:KAI
Last Name:WU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1325 E CHURCH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5909
Mailing Address - Country:US
Mailing Address - Phone:805-925-2529
Mailing Address - Fax:805-928-4478
Practice Address - Street 1:100 CASA ST STE C
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-8804
Practice Address - Country:US
Practice Address - Phone:805-541-1932
Practice Address - Fax:805-541-1653
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2022-10-21
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Provider Licenses
StateLicense IDTaxonomies
CAA1062732085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1336331289Medicaid