Provider Demographics
NPI:1124185269
Name:CHIU, PETER P (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:P
Last Name:CHIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 IRVING ST STE 207
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2121
Mailing Address - Country:US
Mailing Address - Phone:415-753-1888
Mailing Address - Fax:415-753-2190
Practice Address - Street 1:1200 IRVING ST STE 207
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2121
Practice Address - Country:US
Practice Address - Phone:415-753-1888
Practice Address - Fax:415-753-2190
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice