Provider Demographics
NPI:1538649116
Name:CHAD WU, MD, INC
Entity Type:Organization
Organization Name:CHAD WU, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHADWICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-640-5768
Mailing Address - Street 1:8583 IRVINE CENTER DR # 288
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4298
Mailing Address - Country:US
Mailing Address - Phone:949-505-8882
Mailing Address - Fax:949-529-2128
Practice Address - Street 1:15825 LAGUNA CANYON RD STE 105
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2126
Practice Address - Country:US
Practice Address - Phone:949-505-8882
Practice Address - Fax:949-529-2128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1426562086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty