Provider Demographics
NPI:1760522312
Name:CHU KING, ANNABELLA (DMD)
Entity Type:Individual
Prefix:MISS
First Name:ANNABELLA
Middle Name:
Last Name:CHU KING
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ANNABELLA
Other - Middle Name:B
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2105 BEVERLY BLVD
Mailing Address - Street 2:STE. 215
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2273
Mailing Address - Country:US
Mailing Address - Phone:213-413-4444
Mailing Address - Fax:213-413-2247
Practice Address - Street 1:2105 BEVERLY BLVD
Practice Address - Street 2:STE. 215
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2216
Practice Address - Country:US
Practice Address - Phone:213-413-4444
Practice Address - Fax:213-413-2247
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice