Provider Demographics
NPI:1346238854
Name:WU, JERWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JERWIN
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 FOREST AVE
Mailing Address - Street 2:SUITE 134
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1448
Mailing Address - Country:US
Mailing Address - Phone:408-971-1122
Mailing Address - Fax:408-971-3528
Practice Address - Street 1:2101 FOREST AVE
Practice Address - Street 2:SUITE 134
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1448
Practice Address - Country:US
Practice Address - Phone:408-971-1122
Practice Address - Fax:408-971-3528
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38673207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine