| Dr Wu PC | |
|
1525 Fair Oaks Ave South Pasadena CA 91030-3835 | |
| (626) 403-6500 | |
| Not Available |
| Full Name | Dr Wu PC |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1525 Fair Oaks Ave, South Pasadena, California |
| Authorized Official Name and Position | Jo Ann Rice (CREDENTIALING MANAGER) |
| Authorized Official Contact | 4708818679 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Wu PC 2970 Brandywine Rd Ste 200 Atlanta GA 30341-5549 Ph: (770) 692-1000 | Dr Wu PC 1525 Fair Oaks Ave South Pasadena CA 91030-3835 Ph: (626) 403-6500 |
| NPI Number | 1801555123 |
|---|---|
| Provider Enumeration Date | 12/14/2021 |
| Last Update Date | 12/14/2021 |
| Certification Date | 12/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801555123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Primary |
| 261QD0000X | Clinic/center - Dental | () | Secondary |
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