Provider Demographics
NPI:1518093509
Name:CHU, NEAL J (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:J
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 1:7040 AVENIDA ENCINAS
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4653
Mailing Address - Country:US
Mailing Address - Phone:760-431-9211
Mailing Address - Fax:
Practice Address - Street 1:7040 AVENIDA ENCINAS
Practice Address - Street 2:SUITE 102
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4653
Practice Address - Country:US
Practice Address - Phone:760-431-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice