Provider Demographics
NPI:1780685388
Name:TING, EMILIA CHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILIA
Middle Name:CHUA
Last Name:TING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 E SHAW AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7813
Mailing Address - Country:US
Mailing Address - Phone:559-221-7251
Mailing Address - Fax:559-221-7614
Practice Address - Street 1:1095 E SHAW AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7813
Practice Address - Country:US
Practice Address - Phone:559-221-7251
Practice Address - Fax:559-221-7614
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-04
Last Update Date:2007-07-09
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
CAA31181208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A311810Medicaid