Provider Demographics
NPI:1295919090
Name:WU, CECILIA DIMING (PHARM D)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:DIMING
Last Name:WU
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4448 YORK BLVD.
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-3328
Mailing Address - Country:US
Mailing Address - Phone:323-702-4856
Mailing Address - Fax:323-344-5237
Practice Address - Street 1:4448 YORK BLVD.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-3328
Practice Address - Country:US
Practice Address - Phone:323-702-4856
Practice Address - Fax:323-344-5237
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA573831835P0018X, 1835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care