Provider Demographics
NPI:1588656847
Name:CHYU, PHILIP YOUNG-SUH (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:YOUNG-SUH
Last Name:CHYU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 OAK GROVE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2520
Mailing Address - Country:US
Mailing Address - Phone:925-296-7150
Mailing Address - Fax:925-296-7171
Practice Address - Street 1:411 30TH ST
Practice Address - Street 2:#508
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:925-274-4950
Practice Address - Fax:925-274-4950
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA711472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAN630YMedicare PIN
CAH00511Medicare UPIN
CA00A711472Medicare PIN
CA00A711471Medicare PIN
CACH072Medicare PIN