Provider Demographics
NPI:1790035632
Name:CHU, TERRY (DPT)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:CHU
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13163 FOUNTAIN PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2040
Mailing Address - Country:US
Mailing Address - Phone:310-823-2220
Mailing Address - Fax:
Practice Address - Street 1:13163 FOUNTAIN PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:PLAYA VISTA
Practice Address - State:CA
Practice Address - Zip Code:90094-2040
Practice Address - Country:US
Practice Address - Phone:310-823-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist