Provider Demographics
NPI:1972768216
Name:CHU, JEFFREY TING-YUAN (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:TING-YUAN
Last Name:CHU
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1820 41ST AVE STE D
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2516
Practice Address - Country:US
Practice Address - Phone:831-476-3000
Practice Address - Fax:831-476-9009
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP422208000000X
MDD0067792208000000X, 208M00000X
DCMD041400208000000X
FLME122576208000000X
TXP4431208000000X
CAC152161208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist