Provider Demographics
NPI:1962823906
Name:CHU, ALVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:
Last Name:CHU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LAKES DR STE 405
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2927
Mailing Address - Country:US
Mailing Address - Phone:626-489-3488
Mailing Address - Fax:
Practice Address - Street 1:923 S SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2743
Practice Address - Country:US
Practice Address - Phone:626-286-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA630491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice