Provider Demographics
NPI:1093059610
Name:ANNIE CHIU MD, INC
Entity Type:Organization
Organization Name:ANNIE CHIU MD, INC
Other - Org Name:THE DERM INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-939-9800
Mailing Address - Street 1:1636 AVIATION BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-2851
Mailing Address - Country:US
Mailing Address - Phone:310-939-9800
Mailing Address - Fax:310-939-9888
Practice Address - Street 1:1636 AVIATION BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-2851
Practice Address - Country:US
Practice Address - Phone:310-939-9800
Practice Address - Fax:310-939-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty