Jack J Wu MD Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A93228 Issued in CA

Legal business name

JACK J WU MD INC

Practice address

5363 Balboa Blvd Ste 245
Encino, CA 91316-2827

Phone

(818) 693-1431

Fax

(818) 914-0223

NPI assigned

Oct 4, 2010

Organization subpart

No

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

Authorized official

Name

Jack Wu, M.D.NPI 1457512584

Title

President

Phone

(818) 220-7853

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Jack Jyh-Perng Wu, MD

  • Psychiatry Physician
  • Calabasas, CA
  • NPI 1457512584
  Medicare reassignment Care Compare group NPD Authorized official
• Kyle Joseph Bechaz, M.D.

  • Geriatric Psychiatry Physician
  • Los Angeles, CA
  • NPI 1497042287
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1235448697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 PLATT AVE",
            "address_2": "#726",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913073218",
            "telephone_number": "818-220-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD STE 245",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162827",
            "telephone_number": "818-693-1431",
            "fax_number": "818-914-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK J WU MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-04",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-220-7853",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A93228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jack Gaines a Professional Corp.
• Jack Purdy MD Inc
• Aeryka Lavonne Jackson
• Emmanuel Jackson
• Jacob Lilley Chiropractic Inc
• Jacob Reznik MD, Inc., a Professional Corporation

• Psychiatry Physician in Encino, CA
• Providers in Encino, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.