Provider Demographics
NPI:1952509440
Name:ANA CHU, MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ANA CHU, MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:NMN
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-244-2628
Mailing Address - Street 1:3535 E COAST HWY
Mailing Address - Street 2:SUITE 54
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2404
Mailing Address - Country:US
Mailing Address - Phone:949-244-2628
Mailing Address - Fax:949-706-9861
Practice Address - Street 1:25211 PASEO DE ALICIA
Practice Address - Street 2:SUITE 100
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4614
Practice Address - Country:US
Practice Address - Phone:949-900-3480
Practice Address - Fax:949-900-3484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56006207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABX221AMedicare PIN
CABX221AMedicare PIN