Provider Demographics
NPI:1073680609
Name:TU, ROSEMARY TING (MD)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:TING
Last Name:TU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:T
Other - Last Name:CHEUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5565 GROSSMONT CENTER DR
Mailing Address - Street 2:BLDG.#1, SUITE#112
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3020
Mailing Address - Country:US
Mailing Address - Phone:619-469-5400
Mailing Address - Fax:619-464-1311
Practice Address - Street 1:5565 GROSSMONT CENTER DR
Practice Address - Street 2:BLDG.#1, SUITE#112
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3020
Practice Address - Country:US
Practice Address - Phone:619-469-5400
Practice Address - Fax:619-464-1311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25688207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24540Medicare UPIN
CAWA25688BMedicare ID - Type Unspecified