Provider Demographics
NPI:1710380548
Name:CHU, TIFFANY (PHARM D)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:CHU
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 WELCH RD
Mailing Address - Street 2:APT 811
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1902
Mailing Address - Country:US
Mailing Address - Phone:626-715-5000
Mailing Address - Fax:
Practice Address - Street 1:20572 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-0432
Practice Address - Country:US
Practice Address - Phone:408-253-2005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist