Provider Demographics
NPI:1144345372
Name:WU, JOAN CHIA-CHIU (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:CHIA-CHIU
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 UCLA MEDICAL PLZ
Mailing Address - Street 2:SUITE 730
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6970
Mailing Address - Country:US
Mailing Address - Phone:310-209-1440
Mailing Address - Fax:310-209-0070
Practice Address - Street 1:100 UCLA MEDICAL PLZ
Practice Address - Street 2:SUITE 730
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-6970
Practice Address - Country:US
Practice Address - Phone:310-209-1440
Practice Address - Fax:310-209-0070
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA75942207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH00767Medicare UPIN