Provider Demographics
NPI:1275977498
Name:CHUA, GEORGE LOPEZ (NP-C, MSN, RN)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:LOPEZ
Last Name:CHUA
Suffix:
Gender:M
Credentials:NP-C, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N. BEAUDRY AVENUE,
Mailing Address - Street 2:NURSING SERVICES, ROYBAL ANNEX
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2009
Mailing Address - Country:US
Mailing Address - Phone:213-202-7580
Mailing Address - Fax:213-580-6558
Practice Address - Street 1:121 N BEAUDRY AVENUE,
Practice Address - Street 2:NURSING SERVICES, ROYBAL ANNEX
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2009
Practice Address - Country:US
Practice Address - Phone:213-202-7580
Practice Address - Fax:213-580-6558
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA675609363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool