Provider Demographics
NPI:1396024600
Name:WU, EIJEAN (MD, MPP)
Entity Type:Individual
Prefix:
First Name:EIJEAN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD, MPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N VERMONT AVE STE 1001
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6098
Mailing Address - Country:US
Mailing Address - Phone:323-473-5499
Mailing Address - Fax:323-984-9111
Practice Address - Street 1:1300 N VERMONT AVE STE 1001
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-473-5499
Practice Address - Fax:323-984-9111
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117540207VX0201X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology