Provider Demographics
NPI:1740625813
Name:WU, JONATHAN YUN-HONG (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:YUN-HONG
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 1:55 S RAYMOND AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-7101
Mailing Address - Country:US
Mailing Address - Phone:626-289-9004
Mailing Address - Fax:626-289-8952
Practice Address - Street 1:55 S RAYMOND AVE STE 105
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-7101
Practice Address - Country:US
Practice Address - Phone:626-289-9004
Practice Address - Fax:626-289-8952
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40063208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice