Provider Demographics
NPI:1326009275
Name:CHUA, WILLY NG (MD)
Entity Type:Individual
Prefix:
First Name:WILLY
Middle Name:NG
Last Name:CHUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:89 PAINTED TRELLIS
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2306
Mailing Address - Country:US
Mailing Address - Phone:786-229-1336
Mailing Address - Fax:305-545-5220
Practice Address - Street 1:44605 AVENIDA DE MISSIONES STE 206
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592
Practice Address - Country:US
Practice Address - Phone:951-200-5154
Practice Address - Fax:951-302-0800
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME054079207RP1001X
CAA50664207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB324574OtherCALIFORNIA MEDICARE (NORIDIAN)
FL260460400Medicaid
FL35948Medicare ID - Type Unspecified