Provider Demographics
NPI:1598921272
Name:WU, DARRELL (MD)
Entity Type:Individual
Prefix:
First Name:DARRELL
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 1:11326 EUCALYPTUS HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-1209
Mailing Address - Country:US
Mailing Address - Phone:619-823-3146
Mailing Address - Fax:619-554-8500
Practice Address - Street 1:2130 CITRACADO PKWY STE 220
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4151
Practice Address - Country:US
Practice Address - Phone:619-823-3146
Practice Address - Fax:619-554-8500
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA167955208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)