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General NPI Number Information
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NPI Number | 1083484166
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Entity Type | Organization
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Legal Business Name | TINA WU, MD; INTERNAL MEDICINE; A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 15215 NATIONAL AVE STE 200
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City | LOS GATOS
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State | CA
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Zip | 95032-2425
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Country | US
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Telephone | 408-358-1841
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Fax |
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Provider Business Mailing Address
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Address Line | 21701 STEVENS CREEK BLVD UNIT 922
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City | CUPERTINO
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State | CA
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Zip | 95015-3337
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TINA WU
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Credential | MD
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Telephone | 831-216-8118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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