Provider Demographics
NPI:1265494256
Name:CHEW, JOHN Y (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:Y
Last Name:CHEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 SUNNYCREST DR
Mailing Address - Street 2:STE 108
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3654
Mailing Address - Country:US
Mailing Address - Phone:714-441-0133
Mailing Address - Fax:714-441-1082
Practice Address - Street 1:1955 SUNNYCREST DR
Practice Address - Street 2:STE 108
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3654
Practice Address - Country:US
Practice Address - Phone:714-441-0133
Practice Address - Fax:714-441-1082
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG17171207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG17171Medicare ID - Type Unspecified
A40005Medicare UPIN