Provider Demographics
NPI:1386452498
Name:WU, I-HSUAN
Entity type:Individual
Prefix:
First Name:I-HSUAN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 SANTA ANITA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2455
Mailing Address - Country:US
Mailing Address - Phone:626-758-1000
Mailing Address - Fax:626-758-1028
Practice Address - Street 1:3580 SANTA ANITA AVE STE B
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2455
Practice Address - Country:US
Practice Address - Phone:626-758-1000
Practice Address - Fax:626-758-1028
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist