Provider Demographics
NPI:1659387892
Name:WU, DERRINA L (MD)
Entity Type:Individual
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First Name:DERRINA
Middle Name:L
Last Name:WU
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1044 TARAVAL ST
Mailing Address - Street 2:303
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-2423
Mailing Address - Country:US
Mailing Address - Phone:415-566-3808
Mailing Address - Fax:415-566-3837
Practice Address - Street 1:3580 CALIFORNIA ST
Practice Address - Street 2:303
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1725
Practice Address - Country:US
Practice Address - Phone:415-563-8686
Practice Address - Fax:415-563-8910
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2017-03-15
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Provider Licenses
StateLicense IDTaxonomies
CAG80622207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH16491Medicare UPIN