Provider Demographics
NPI:1437178803
Name:WU, GLORIA (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2550 SAMARITAN DR.
Mailing Address - Street 2:STE C
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124
Mailing Address - Country:US
Mailing Address - Phone:408-356-5553
Mailing Address - Fax:408-356-5556
Practice Address - Street 1:2550 SAMARITAN DR.
Practice Address - Street 2:STE C
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124
Practice Address - Country:US
Practice Address - Phone:408-356-5553
Practice Address - Fax:408-356-5556
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-06-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG59994207W00000X
MA54626207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G599940Medicare ID - Type Unspecified