Provider Demographics
NPI:1699730077
Name:WU, TZUYING TAMMY (MD)
Entity type:Individual
Prefix:
First Name:TZUYING
Middle Name:TAMMY
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 MEDINAH WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-9735
Mailing Address - Country:US
Mailing Address - Phone:209-918-0188
Mailing Address - Fax:209-342-3757
Practice Address - Street 1:2336 SYLVAN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9294
Practice Address - Country:US
Practice Address - Phone:209-918-0188
Practice Address - Fax:209-342-3757
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83075208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery