Provider Demographics
NPI:1285686592
Name:CHIU, PAO Y (MD)
Entity Type:Individual
Prefix:DR
First Name:PAO
Middle Name:Y
Last Name:CHIU
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 1:17117 LEAL AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1337
Mailing Address - Country:US
Mailing Address - Phone:213-268-4168
Mailing Address - Fax:213-268-4168
Practice Address - Street 1:1225 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2395
Practice Address - Country:US
Practice Address - Phone:213-977-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82770207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A827700Medicaid
CA00A827700OtherBLUE SHIELD
CA00A827700OtherCALOPTIMA
CA050126CH96839OtherVALLEY PRES TRAILBLAZER
CA050471CH96839OtherGOOD SAM TRAILBLAZER
CAP00230519OtherRAILROAD MEDICARE
CAA82770OtherBLUE CROSS
CA050126CH96839OtherVALLEY PRES TRAILBLAZER
CA050471CH96839OtherGOOD SAM TRAILBLAZER
CAA82770OtherBLUE CROSS