Individual provider Active NPI

Eric Wu

  • Sports Medicine (Family Medicine) Physician
  • Anaheim, CA
National Provider Identifier
1497319149
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
20A21371 Issued in CA
Practice address
1325 N Anaheim Blvd Ste 200
Anaheim, CA 92801-1202
Phone
(888) 499-9303
NPI assigned
Apr 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A21371 CA
Sports Medicine (Family Medicine) Physician 207QS0010X 20A21371 CA Primary

Addresses

Primary practice location

1325 N Anaheim Blvd Ste 200
Anaheim, CA 92801-1202

Mailing address

16547 Blackburn Dr
La Mirada, CA 90638-6206
Phone (714) 523-1515

Other practice location 1

16547 Blackburn Dr
LA Mirada, CA 90638-6206
Phone (714) 523-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920004481 CA Order and Referring Only - Family PracticePractitioner - Family PracticePractitioner - Sports Medicine 7315303773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A21371CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1497319149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16547 BLACKBURN DR",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906386206",
            "telephone_number": "714-523-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 N ANAHEIM BLVD STE 200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011202",
            "telephone_number": "888-499-9303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16547 Blackburn Dr",
            "address_purpose": "LOCATION",
            "city": "LA Mirada",
            "state": "CA",
            "postal_code": "906386206",
            "country_code": "US",
            "telephone_number": "714-523-1515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WU",
        "first_name": "ERIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21371",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A21371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.