Provider Demographics
NPI:1831106525
Name:WU, LI-CHIH (MD)
Entity Type:Individual
Prefix:DR
First Name:LI-CHIH
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 1:600 N GARFIELD AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754
Mailing Address - Country:US
Mailing Address - Phone:626-573-1553
Mailing Address - Fax:626-573-2160
Practice Address - Street 1:600 N GARFIELD AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:626-573-1553
Practice Address - Fax:626-573-2160
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41762208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A417620Medicaid
CA00A417620Medicaid
A85696Medicare UPIN