Provider Demographics
NPI:1386653657
Name:WU, HONG (MD)
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 E HILLSDALE BLVD
Mailing Address - Street 2:APT A203
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1261
Mailing Address - Country:US
Mailing Address - Phone:650-533-7853
Mailing Address - Fax:
Practice Address - Street 1:1510 4TH ST
Practice Address - Street 2:SUITE1
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-1717
Practice Address - Country:US
Practice Address - Phone:510-525-8980
Practice Address - Fax:510-525-8982
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92464207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A924640Medicaid
I57032Medicare UPIN
CA00A924640Medicaid