Provider Demographics
NPI:1760579130
Name:ZHANG, CHU (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHU
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 W MAIN ST
Mailing Address - Street 2:#B
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1775
Mailing Address - Country:US
Mailing Address - Phone:626-320-4608
Mailing Address - Fax:
Practice Address - Street 1:1440 W MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-5422
Practice Address - Country:US
Practice Address - Phone:323-753-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist