Provider Demographics
NPI:1467634022
Name:CHU, CINDY WING-SAN (MSN, FNP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:WING-SAN
Last Name:CHU
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 HILLHURST AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5516
Mailing Address - Country:US
Mailing Address - Phone:323-644-3888
Mailing Address - Fax:
Practice Address - Street 1:1530 HILLHURST AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5516
Practice Address - Country:US
Practice Address - Phone:323-644-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA527595363LF0000X
CANPF10078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABH495ZMedicare PIN