Provider Demographics
NPI:1023185915
Name:CHU, NANCY C (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:CHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2789 SUNRIDGE HEIGHTS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5052
Mailing Address - Country:US
Mailing Address - Phone:702-614-0850
Mailing Address - Fax:702-614-0987
Practice Address - Street 1:2789 SUNRIDGE HEIGHTS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5052
Practice Address - Country:US
Practice Address - Phone:702-614-0850
Practice Address - Fax:702-614-0987
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12713207Q00000X
CAA76589207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A765890Medicaid
H71333Medicare UPIN