MEDICARE: NEW VALLEY MEDICAL GROUP INC

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	207R00000X	Internal Medicine Physician	A46692	CA

General Provider Information

NPI Number	:	1669612297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW VALLEY MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	415 W VALLEY BLVD
Second Line	:	SUITE C
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-3728
Country	:	US
Telephone Number	:	626-943-9240
Fax Number	:	626-943-9242

Provider Business Practice Location Address
First Line	:	415 W VALLEY BLVD
Second Line	:	SUITE C
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-3728
Country	:	US
Telephone Number	:	626-943-9240
Fax Number	:	626-943-9242

Authorized Official
Title or Position	:	M.D.
Name	:	DR. TAI HING WU
Credential	:	M.D.
Telephone Number	:	626-943-9240

Provider Enumeration Date	:	02/22/2009
Last Update Date	:	05/25/2010

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Directions to “NEW VALLEY MEDICAL GROUP INC ” Practice Location

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