Provider Demographics
NPI:1396064614
Name:WU, VINCENT C (DO)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:C
Last Name:WU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:623 W NORMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7919
Mailing Address - Country:US
Mailing Address - Phone:626-353-2228
Mailing Address - Fax:
Practice Address - Street 1:100 S RAYMOND AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3166
Practice Address - Country:US
Practice Address - Phone:626-458-4674
Practice Address - Fax:626-656-6012
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1396064614207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine