Basic Information
| Provider Information | |||||||||
| NPI: | 1720142300 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WU'S ANESTHESIA P A SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 60790 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911166790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6267956596 | ||||||||
| FaxNumber: | 6267958247 | ||||||||
| Practice Location | |||||||||
| Address1: | 3751 KATELLA AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ALAMITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907203101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625971311 | ||||||||
| FaxNumber: | 5627993133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2006 | ||||||||
| LastUpdateDate: | 07/28/2011 | ||||||||
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| AuthorizedOfficialLastName: | WU | ||||||||
| AuthorizedOfficialFirstName: | GUOSHENG | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8188456206 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A86920 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 00A869200 | 01 | CA | BLUE SHIELD | OTHER | 00A869200 | 05 | CA | MEDICAID |