| Community Internal Medicine, Inc. | |
|
7880 Wren Ave. Suite # D-143 Gilroy CA 95020-7802 | |
| (408) 846-1800 | |
| (408) 846-1995 |
| Full Name | Community Internal Medicine, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 7880 Wren Ave., Gilroy, California |
| Authorized Official Name and Position | Samuel Wendong Wu (OWNER AND CEO) |
| Authorized Official Contact | 4085009773 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Internal Medicine, Inc. 7880 Wren Ave. Suite # D-143 Gilroy CA 95020-7802 Ph: (408) 846-1800 | Community Internal Medicine, Inc. 7880 Wren Ave. Suite # D-143 Gilroy CA 95020-7802 Ph: (408) 846-1800 |
| NPI Number | 1710183512 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 04/20/2024 |
| Medicare PECOS PAC ID | 4587751052 |
|---|---|
| Medicare Enrollment ID | O20071030000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710183512 | NPI | - | NPPES |
| 00A740740 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A740740 (California) | Primary |
| Provider Name | Samuel Wendong Wu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659329993 PECOS PAC ID: 5496842965 Enrollment ID: I20071030000653 |
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