Provider Demographics
NPI:1669574059
Name:WU, ROBERT K (M D)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:WU
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:13847 E 14TH ST
Mailing Address - Street 2:#200
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2632
Mailing Address - Country:US
Mailing Address - Phone:510-352-5470
Mailing Address - Fax:510-352-3154
Practice Address - Street 1:13847 E 14TH ST
Practice Address - Street 2:#200
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2632
Practice Address - Country:US
Practice Address - Phone:510-352-5470
Practice Address - Fax:510-352-3154
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-02-02
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Provider Licenses
StateLicense IDTaxonomies
CAG74241207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G742410Medicaid
CA00G742410Medicare PIN
CAF95843Medicare UPIN