Individual
JONATHAN WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7525 METROPOLITAN DR STE 306, SAN DIEGO, CA 92108-4404
(844) 316-7979
(866) 813-1235
Mailing address
PO BOX 722982, SAN DIEGO, CA 92172-2982
(858) 349-8085
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA18550
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA18550
PA LICENSE
CA
Enumeration date
10/11/2006
Last updated
12/19/2019
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