Healthcare Provider Details

I. General information

NPI: 1194876995
Provider Name (Legal Business Name): MIN-SHUNG WU M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 W OAK AVE
VISALIA CA
93291-6039
US

IV. Provider business mailing address

PO BOX 2691
VISALIA CA
93279-2691
US

V. Phone/Fax

Practice location:
  • Phone: 559-741-9889
  • Fax:
Mailing address:
  • Phone: 559-741-9889
  • Fax: 559-741-9338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA51671
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA51671
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberA51671
License Number StateCA

VIII. Authorized Official

Name: TINA WU
Title or Position: MANAGER
Credential:
Phone: 559-739-8328