Provider Demographics
NPI:1417162678
Name:EMILIO C. CHU M.D. INC.
Entity Type:Organization
Organization Name:EMILIO C. CHU M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-970-0937
Mailing Address - Street 1:20230 CHANDLER DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-3260
Mailing Address - Country:US
Mailing Address - Phone:714-970-0937
Mailing Address - Fax:
Practice Address - Street 1:20230 CHANDLER DR
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-3260
Practice Address - Country:US
Practice Address - Phone:714-970-0937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-035512261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA74909Medicare UPIN
OHEM9188351Medicare ID - Type Unspecified