Provider Demographics
NPI:1871093302
Name:WU, CAROLINE (PHARMD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 STARLIT LN
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-1825
Mailing Address - Country:US
Mailing Address - Phone:626-261-3829
Mailing Address - Fax:
Practice Address - Street 1:1950 AUTO CENTRE DR
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6700
Practice Address - Country:US
Practice Address - Phone:909-599-3955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist