Provider Demographics
NPI:1689734980
Name:CHIU, ANDERSON HUNG (LAC)
Entity Type:Individual
Prefix:MR
First Name:ANDERSON
Middle Name:HUNG
Last Name:CHIU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S ORANGE AVE APT C
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-7568
Mailing Address - Country:US
Mailing Address - Phone:626-665-6968
Mailing Address - Fax:
Practice Address - Street 1:425 S ORANGE AVE APT C
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-7568
Practice Address - Country:US
Practice Address - Phone:626-665-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA97810Medicaid