Provider Demographics
NPI:1376772368
Name:CHU, LAI KUEN (RN)
Entity Type:Individual
Prefix:MS
First Name:LAI
Middle Name:KUEN
Last Name:CHU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VICKY
Other - Middle Name:
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1520 STOCKTON ST
Mailing Address - Street 2:C/O NORTH EAST MEDICAL SERVICES
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-3354
Mailing Address - Country:US
Mailing Address - Phone:415-391-9686
Mailing Address - Fax:415-433-4726
Practice Address - Street 1:1715 LUNDY AVE
Practice Address - Street 2:SUITES 108-116
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-1837
Practice Address - Country:US
Practice Address - Phone:408-573-9686
Practice Address - Fax:408-573-9685
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA696477163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health