Provider Demographics
NPI:1457185787
Name:RICHARD WU, O.D., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:RICHARD WU, O.D., A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHUN-NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-200-7219
Mailing Address - Street 1:7129 NE IMBRIE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7594
Mailing Address - Country:US
Mailing Address - Phone:415-200-7219
Mailing Address - Fax:
Practice Address - Street 1:4299 ROSEWOOD DRIVE
Practice Address - Street 2:UNIT 105
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588
Practice Address - Country:US
Practice Address - Phone:925-416-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty