Individual
CHARLES WU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1326
Mailing address
1832 MONTAGE CT, SAN JOSE, CA 95131-3421
(408) 628-8147
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-F24-TA-C96
AL
Other
Enumeration date
06/12/2023
Last updated
04/05/2024
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