Provider Demographics
NPI:1184064727
Name:CHU, CHRISTINE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:CHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:626 S PRIMROSE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-3434
Mailing Address - Country:US
Mailing Address - Phone:626-775-5118
Mailing Address - Fax:626-509-8200
Practice Address - Street 1:626 S PRIMROSE AVE
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-3434
Practice Address - Country:US
Practice Address - Phone:626-775-5118
Practice Address - Fax:626-509-8200
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA610871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry