Provider Demographics
NPI:1003958281
Name:WAN YI CHU & CHAO KUEI CHEN DDS INC
Entity Type:Organization
Organization Name:WAN YI CHU & CHAO KUEI CHEN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAN YI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS DENTIST
Authorized Official - Phone:626-448-4288
Mailing Address - Street 1:10990 LOWER AZUSA RD
Mailing Address - Street 2:#6
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731
Mailing Address - Country:US
Mailing Address - Phone:626-448-4288
Mailing Address - Fax:626-448-1978
Practice Address - Street 1:10990 LOWER AZUSA RD
Practice Address - Street 2:#6
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731
Practice Address - Country:US
Practice Address - Phone:626-448-4288
Practice Address - Fax:626-448-1978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39950141067122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9175001OtherDENTI CAL