Provider Demographics
NPI:1710357579
Name:PEI-CHI WU DO A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:PEI-CHI WU DO A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:DB MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEI-CHI
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:909-861-6853
Mailing Address - Street 1:2020 S BREA CANYON RD STE A1
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4012
Mailing Address - Country:US
Mailing Address - Phone:909-861-6853
Mailing Address - Fax:909-963-1796
Practice Address - Street 1:2020 S BREA CANYON RD STE A1
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4012
Practice Address - Country:US
Practice Address - Phone:909-861-6853
Practice Address - Fax:909-963-1796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10934261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care