Jeng Ren Wu, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C39737 Issued in CA

Practice address

355 E 21St St
Suite G
San Bernardino, CA 92404-4851

Phone

(909) 886-8618

Fax

(909) 886-3935

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Chris Jeng-Ren Wu Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487766069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E 21ST STREET",
            "address_2": "SUITE G",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043808",
            "telephone_number": "909-886-8618",
            "fax_number": "909-886-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E 21ST ST",
            "address_2": "SUITE G",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044851",
            "telephone_number": "909-886-8618",
            "fax_number": "909-886-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "JENG",
        "middle_name": "REN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C39737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C397370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRIS",
            "last_name": "WU",
            "middle_name": "JENG-REN",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Wound Healing Recovery Corporation
• Wound Rescue Specialist
• Morgan Astin Wray
• Chela Fontaine Wright, MD
• Richard Charles Wright, AMFT
• Lashawnda M Wyatt
• Quonteisha Wymbs
• Mariah I Wysinger
• Zuelika Cristina Xicotencatl
• Mike Xing, DDS

• Family Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.