Provider Demographics
NPI:1588806814
Name:CHU & YANG DDS A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:CHU & YANG DDS A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-771-8571
Mailing Address - Street 1:731 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1620
Mailing Address - Country:US
Mailing Address - Phone:714-771-8571
Mailing Address - Fax:714-771-2888
Practice Address - Street 1:731 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1620
Practice Address - Country:US
Practice Address - Phone:714-771-8571
Practice Address - Fax:714-771-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30474122300000X
CA57627122300000X
CA30504122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6485650001Medicare NSC