Provider Demographics
NPI:1477553485
Name:CHU, DAVID Z (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:Z
Last Name:CHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 386
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91778-0386
Mailing Address - Country:US
Mailing Address - Phone:626-300-8880
Mailing Address - Fax:800-300-8811
Practice Address - Street 1:416 W LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1236
Practice Address - Country:US
Practice Address - Phone:626-300-8880
Practice Address - Fax:626-300-8811
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG326092086X0206X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G32609Medicare ID - Type UnspecifiedMEDICARE PROVIDER
C68008Medicare UPIN