MEDICARE: MICHELLE TU

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	183500000X	Pharmacist	PH240210	MA
2	183500000X	Pharmacist	76610	CA

General Provider Information

NPI Number	:	1790434009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE TU

Provider Business Mailing Address
First Line	:	4718 HOLLY AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-6785
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4718 HOLLY AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-6785
Country	:	US
Telephone Number	:	562-822-6431
Fax Number	:

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

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	03/22/2022

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Directions to “ MICHELLE TU ” Practice Location

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