Organization Active NPI

Wu Pediatrics Corp

  • Pediatrics Physician
  • Temple City, CA
National Provider Identifier
1831565670
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A101672 Issued in CA
Legal business name
WU PEDIATRICS CORP
Practice address
5817 Temple City Blvd
Temple City, CA 91780-2113
Phone
(626) 285-1254
NPI assigned
Aug 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Authorized official

Name
Dr. Derek J Wu, M.D.NPI 1164616223
Title
President
Phone
(626) 285-1254

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A101672 CA Primary

Addresses

Primary practice location

5817 Temple City Blvd
Temple City, CA 91780-2113

Mailing address

5817 Temple City Blvd
Temple City, CA 91780-2113
Phone (626) 285-1254

Other identifiers 1

IdentifierTypeStateIssuer
1164616224MedicaidCA

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
05D2101815Wu Pediatrics Corp5817 Temple City Blvd, Temple City, CA 91780Certificate of waiverSep 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Wu Pediatrics Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5817 Temple City Blvd
Temple City, CA 91780
Phone (626) 282-1254

Practitioners & affiliated clinicians

Practitioners 3

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": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1831565670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5817 TEMPLE CITY BLVD",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917802113",
            "telephone_number": "626-285-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5817 TEMPLE CITY BLVD",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917802113",
            "telephone_number": "626-285-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WU PEDIATRICS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-285-1254",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A101672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164616224",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.