Provider Demographics
NPI:1326121716
Name:CHIU, JOHN T (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:CHIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:400 NEWPORT CENTER DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7601
Mailing Address - Country:US
Mailing Address - Phone:949-644-1422
Mailing Address - Fax:949-644-1424
Practice Address - Street 1:400 NEWPORT CENTER DR
Practice Address - Street 2:SUITE 401
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-644-1422
Practice Address - Fax:949-644-1424
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2018-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG13693207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ70106ZOtherBLUE SHIELD
CAZZZ70106ZMedicaid
CAA25541Medicare UPIN
CAZZZ70106ZMedicaid