Provider Demographics
NPI:1407135783
Name:CHU ZHANG DDS INC
Entity Type:Organization
Organization Name:CHU ZHANG DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHU
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-670-1100
Mailing Address - Street 1:1532 SAN BERNARDINO AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3559
Mailing Address - Country:US
Mailing Address - Phone:909-670-1100
Mailing Address - Fax:909-398-0026
Practice Address - Street 1:1532 SAN BERNARDINO AVE STE A1
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3559
Practice Address - Country:US
Practice Address - Phone:909-670-1100
Practice Address - Fax:909-398-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54545261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental