Provider Demographics
NPI:1619187440
Name:CHIU, LI-CHUN (DDS)
Entity Type:Individual
Prefix:
First Name:LI-CHUN
Middle Name:
Last Name:CHIU
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 1:18906 GALE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1333
Mailing Address - Country:US
Mailing Address - Phone:626-965-5618
Mailing Address - Fax:
Practice Address - Street 1:18906 GALE AVE STE B
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-1333
Practice Address - Country:US
Practice Address - Phone:626-965-5618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist