Provider Demographics
NPI:1952832016
Name:CHUA, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CHUA
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 1:1850 S AZUSA AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6827
Mailing Address - Country:US
Mailing Address - Phone:626-912-6888
Mailing Address - Fax:626-913-9281
Practice Address - Street 1:1850 S AZUSA AVE STE 107
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-6827
Practice Address - Country:US
Practice Address - Phone:626-812-6888
Practice Address - Fax:626-913-9281
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
CAA171195207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No282N00000XHospitalsGeneral Acute Care Hospital