Provider Demographics
NPI:1659394096
Name:DAVID Z J CHU MD INC
Entity Type:Organization
Organization Name:DAVID Z J CHU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:Z
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-300-8880
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91778-0386
Mailing Address - Country:US
Mailing Address - Phone:626-300-8880
Mailing Address - Fax:626-300-8811
Practice Address - Street 1:624 W DUARTE RD STE 101
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9257
Practice Address - Country:US
Practice Address - Phone:626-660-5862
Practice Address - Fax:626-237-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32609208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G326090Medicaid
CAC68008Medicare UPIN
CAG32609Medicare ID - Type UnspecifiedPPIN