Individual ProviderNathaly WuNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Ucla Medical Plz Ste 120, Los Angeles, CA 90095-5726(310) 267-6810(310) 301-8707PECOS EnrollmentBased on the most recent information from CMS, provider Nathaly Wu is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1558987743Provider TypeIndividualFull NameWu, NathalyCredentialNPGenderFemaleSole ProprietorNoEnumeration Date6/23/2020Last Updated5/11/2022Contact InformationPractice LocationPractice Address200 Ucla Medical Plz Ste 120, Los Angeles, CA 90095-5726Phone(310) 267-6810FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631Phone(310) 301-8707FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95014730California