Organization Active NPI

Wu Lee Quock Medical Corporation

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1609352665
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WU LEE QUOCK MEDICAL CORPORATION
Practice address
1044 Taraval St
San Francisco, CA 94116-2423
Phone
(415) 216-0088
NPI assigned
Jul 12, 2018
Last updated
Oct 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Derrina Wu, MD
Title
Chief Executive Officer
Phone
(415) 216-0088

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X CA Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

1044 Taraval St
San Francisco, CA 94116-2423

Mailing address

1044 Taraval St
San Francisco, CA 94116-2423
Phone (415) 216-0088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181206003591 CA Part B Supplier - Clinic/Group Practice 9638413347 Receives reassigned benefits from 8 practitioners
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

Locations

490 Post St
Ste 500
San Francisco, CA 94102
Phone (415) 421-2256

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1609352665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 TARAVAL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162423",
            "telephone_number": "415-216-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 TARAVAL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162423",
            "telephone_number": "415-216-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WU LEE QUOCK MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "DERRINA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "415-216-0088",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.