Provider Demographics
NPI:1982701918
Name:TU, RICHARD T (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:TU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE STE 180
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0303
Practice Address - Country:US
Practice Address - Phone:916-536-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54032207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMCMG299500OtherWESTERN HEALTH ADVANTAGE
CA00A540320Medicaid
CA7307489OtherAETNA
CA314279OtherINTERPLAN
CA90138927OtherPACIFICARE
CAA54032OtherBLUE CROSS
CA000810574854OtherPHCS
CA00A540320OtherBLUE SHIELD
CA104583OtherHEALTH NET
CA1739985OtherGREAT WEST
CA5105188OtherCIGNA
CA2125739OtherUNITED HEALTHCARE
CA5400150OtherFIRST HEALTH
CA00A540320OtherBLUE SHIELD
CA7307489OtherAETNA