Provider Demographics
NPI:1093179004
Name:WU, HENRY CHENG-JU (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:CHENG-JU
Last Name:WU
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4729 E SUNRISE DR
Mailing Address - Street 2:PMB 280
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-4534
Mailing Address - Country:US
Mailing Address - Phone:314-620-0905
Mailing Address - Fax:
Practice Address - Street 1:1900 OFARRELL ST STE 190
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1372
Practice Address - Country:US
Practice Address - Phone:650-306-9490
Practice Address - Fax:650-306-0250
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64537207L00000X, 208VP0014X
CAA196806207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0402463Medicaid
OH35.139883OtherOH STATE MEDICAL LICENSE