Provider Demographics
NPI:1891131421
Name:TU, POWEN (MD PHD)
Entity Type:Individual
Prefix:
First Name:POWEN
Middle Name:
Last Name:TU
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 E CONCORD ST
Mailing Address - Street 2:EVANS 124
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2642
Mailing Address - Country:US
Mailing Address - Phone:617-638-6551
Mailing Address - Fax:
Practice Address - Street 1:250 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1103
Practice Address - Country:US
Practice Address - Phone:408-972-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA137485207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program