Provider Demographics
NPI:1639135320
Name:CHU, EDWARD TSIEN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:TSIEN
Last Name:CHU
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 1:300 W CLARENDON AVE
Mailing Address - Street 2:STE 120
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3421
Mailing Address - Country:US
Mailing Address - Phone:602-277-3337
Mailing Address - Fax:602-277-3330
Practice Address - Street 1:300 W CLARENDON AVE
Practice Address - Street 2:STE 120
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3421
Practice Address - Country:US
Practice Address - Phone:602-277-3337
Practice Address - Fax:602-277-3330
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ148892080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ03WCHHZ01Medicare ID - Type Unspecified
D36676Medicare UPIN