Basic Information
| Provider Information | |||||||||
| NPI: | 1184112799 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WU | ||||||||
| FirstName: | SIJIA | ||||||||
| MiddleName: | MAGGIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14350 MERIDIAN PKWY # 2 | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925183035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9518277669 | ||||||||
| FaxNumber: | 9518274280 | ||||||||
| Practice Location | |||||||||
| Address1: | 2081 BRONZE STAR DR | ||||||||
| Address2: | |||||||||
| City: | WOODLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957765423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306682600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2018 | ||||||||
| LastUpdateDate: | 09/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A165671 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.