Provider Demographics
NPI:1437661865
Name:CHU, RICHARD T (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:CHU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 W LONGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-8128
Mailing Address - Country:US
Mailing Address - Phone:626-429-8946
Mailing Address - Fax:
Practice Address - Street 1:413 W LONGDEN AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-8128
Practice Address - Country:US
Practice Address - Phone:626-429-8946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA599081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice