Provider Demographics
NPI:1790914869
Name:CHIU, CHRISTOPHER KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KEVIN
Last Name:CHIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 HAGGIN GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-5955
Mailing Address - Country:US
Mailing Address - Phone:267-257-7600
Mailing Address - Fax:
Practice Address - Street 1:2120 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3700
Practice Address - Country:US
Practice Address - Phone:267-257-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT184190208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery