Provider Demographics
NPI:1225520547
Name:THEODORE J. CHU, MD, ALLERGY AND ASTHMA, INC.
Entity Type:Organization
Organization Name:THEODORE J. CHU, MD, ALLERGY AND ASTHMA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-816-8923
Mailing Address - Street 1:130 BELLEROSE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1729
Mailing Address - Country:US
Mailing Address - Phone:408-816-8923
Mailing Address - Fax:669-242-7914
Practice Address - Street 1:130 BELLEROSE DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1729
Practice Address - Country:US
Practice Address - Phone:408-816-8923
Practice Address - Fax:669-242-7914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG12838207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty