Provider Demographics
NPI:1396943833
Name:SUFEN CHIU, M.D., PSYCHIATRIST, INC.
Entity type:Organization
Organization Name:SUFEN CHIU, M.D., PSYCHIATRIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUFEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-219-2750
Mailing Address - Street 1:PO BOX 73284
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-3284
Mailing Address - Country:US
Mailing Address - Phone:530-219-2750
Mailing Address - Fax:877-844-1699
Practice Address - Street 1:2657 PORTAGE BAY E STE 3
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-3040
Practice Address - Country:US
Practice Address - Phone:530-219-2750
Practice Address - Fax:877-844-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG865932084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G865930Medicaid
CA1336124486OtherINDIVIDUAL NPI
CAG58860Medicare UPIN