1952509440 NPI number — ANA CHU, MD A PROFESSIONAL CORPORATION

Table of content: (NPI 1952509440)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952509440 NPI number — ANA CHU, MD A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANA CHU, MD A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952509440
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3535 E COAST HWY
Provider Second Line Business Mailing Address:
SUITE 54
Provider Business Mailing Address City Name:
CORONA DEL MAR
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92625-2404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-244-2628
Provider Business Mailing Address Fax Number:
949-706-9861

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25211 PASEO DE ALICIA
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LAGUNA HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92653-4614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-900-3480
Provider Business Practice Location Address Fax Number:
949-900-3484
Provider Enumeration Date:
07/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CHU
Authorized Official First Name:
ANA
Authorized Official Middle Name:
NMN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
949-244-2628

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  G56006 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LP2900X , with the licence number: G56006 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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