Provider Demographics
NPI:1528371655
Name:CHU, HANH MY
Entity Type:Individual
Prefix:MRS
First Name:HANH
Middle Name:MY
Last Name:CHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANH
Other - Middle Name:MY
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6367 ALVARADO CT
Mailing Address - Street 2:STE 300
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-4916
Mailing Address - Country:US
Mailing Address - Phone:619-255-5903
Mailing Address - Fax:
Practice Address - Street 1:5565 GROSSMONT CENTER DR
Practice Address - Street 2:BLDG 2, STE 1
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3020
Practice Address - Country:US
Practice Address - Phone:619-567-1550
Practice Address - Fax:619-567-1545
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily