| Jack J Wu Md Inc | |
|
5363 Balboa Blvd Ste 245 Encino CA 91316-2827 | |
| (818) 693-1431 | |
| (818) 914-0223 |
| Full Name | Jack J Wu Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5363 Balboa Blvd Ste 245, Encino, California |
| Authorized Official Name and Position | Jack Wu (PRESIDENT) |
| Authorized Official Contact | 8182207853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack J Wu Md Inc 6520 Platt Ave #726 West Hills CA 91307-3218 Ph: (818) 220-7853 | Jack J Wu Md Inc 5363 Balboa Blvd Ste 245 Encino CA 91316-2827 Ph: (818) 693-1431 |
| NPI Number | 1235448697 |
|---|---|
| Provider Enumeration Date | 10/04/2010 |
| Last Update Date | 11/13/2019 |
| Medicare PECOS PAC ID | 1951529239 |
|---|---|
| Medicare Enrollment ID | O20140828000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235448697 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A93228 (California) | Primary |
| Provider Name | Jack Wu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457512584 PECOS PAC ID: 7618045121 Enrollment ID: I20081010000551 |
| Provider Name | Walter Dunn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124261813 PECOS PAC ID: 2163647173 Enrollment ID: I20140708001126 |
| Provider Name | Andrea R Carter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992091391 PECOS PAC ID: 8527386929 Enrollment ID: I20150415001457 |
| Provider Name | Kyle Bechaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497042287 PECOS PAC ID: 2961793963 Enrollment ID: I20160622001911 |
| Provider Name | Erin S Samplin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811382567 PECOS PAC ID: 5092082248 Enrollment ID: I20170518002759 |
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