Provider Demographics
NPI:1588030126
Name:KOJIMA CHIU, ELAINE (OTD, OTR /L)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:
Last Name:KOJIMA CHIU
Suffix:
Gender:F
Credentials:OTD, OTR /L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1962 PLAZA DEL AMO APT A
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-4447
Mailing Address - Country:US
Mailing Address - Phone:650-690-2325
Mailing Address - Fax:
Practice Address - Street 1:1962 PLAZA DEL AMO APT A
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-4447
Practice Address - Country:US
Practice Address - Phone:650-690-2325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1301225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist