Organization Active NPI

W Dermatology West Covina Inc.

  • Dermatology Physician
  • West Covina, CA
National Provider Identifier
1053282103
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
W DERMATOLOGY WEST COVINA INC.
Practice address
933 S Sunset Ave Ste 301
West Covina, CA 91790-3410
Phone
(626) 960-5464
NPI assigned
Sep 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James G Wu, MDNPI 1851711345
Title
Owner/Dermatologist
Phone
(323) 818-2734

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

933 S Sunset Ave Ste 301
West Covina, CA 91790-3410

Mailing address

933 S Sunset Ave Ste 301
West Covina, CA 91790-3410
Phone (626) 960-5464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251201001588 CA Part B Supplier - Clinic/Group Practice 0042703910 Receives reassigned benefits from 4 practitioners
Practice locations: West Covina, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0688200W Dermatology West Covina933 S Sunset Ave, Ste 301, West Covina, CA 91790ComplianceMar 23, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1053282103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 S SUNSET AVE STE 301",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903410",
            "telephone_number": "626-960-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 S SUNSET AVE STE 301",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903410",
            "telephone_number": "626-960-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W DERMATOLOGY WEST COVINA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/DERMATOLOGIST",
        "authorized_official_telephone_number": "323-818-2734",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.