Provider Demographics
NPI:1821869231
Name:CHUA DY, ANDREA KAYE (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:KAYE
Last Name:CHUA DY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5751 STANTON AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2143
Mailing Address - Country:US
Mailing Address - Phone:909-702-8820
Mailing Address - Fax:
Practice Address - Street 1:5751 STANTON AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2143
Practice Address - Country:US
Practice Address - Phone:909-702-8820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine