Provider Demographics
NPI:1629227251
Name:CHU, DORTHA TAO-YI (MD, PHD,)
Entity Type:Individual
Prefix:DR
First Name:DORTHA
Middle Name:TAO-YI
Last Name:CHU
Suffix:
Gender:F
Credentials:MD, PHD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23004 WEYMOUTH PL
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-2041
Mailing Address - Country:US
Mailing Address - Phone:661-678-3696
Mailing Address - Fax:
Practice Address - Street 1:25425 ORCHARD VILLAGE RD STE 150
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2959
Practice Address - Country:US
Practice Address - Phone:661-467-2371
Practice Address - Fax:661-753-8647
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86342208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0765638Medicaid