MEDICARE: DR. GENE CHANG TU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A60067	CA

General Provider Information

NPI Number	:	1649289505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GENE CHANG TU MD

Provider Business Mailing Address
First Line	:	1330 SOUTH FULLERTON ROAD
Second Line	:	SUITE 288
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748
Country	:	US
Telephone Number	:	626-965-1233
Fax Number	:	626-965-1633

Provider Business Practice Location Address
First Line	:	1330 SOUTH FULLERTON ROAD
Second Line	:	SUITE 288
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748
Country	:	US
Telephone Number	:	626-965-1233
Fax Number	:	626-965-1633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	07/08/2007

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