Provider Demographics
NPI:1225263312
Name:DENNIS A. CHUCK M.D. INC.
Entity Type:Organization
Organization Name:DENNIS A. CHUCK M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-622-1188
Mailing Address - Street 1:1774 ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-1727
Mailing Address - Country:US
Mailing Address - Phone:909-622-1188
Mailing Address - Fax:909-623-4768
Practice Address - Street 1:1774 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-1727
Practice Address - Country:US
Practice Address - Phone:909-622-1188
Practice Address - Fax:909-623-4768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty