Provider Demographics
NPI:1750358768
Name:CHU, QUE ANH (MD)
Entity type:Individual
Prefix:
First Name:QUE
Middle Name:ANH
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 1:2400 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2026
Mailing Address - Country:US
Mailing Address - Phone:619-470-4321
Mailing Address - Fax:
Practice Address - Street 1:2400 E 4TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2026
Practice Address - Country:US
Practice Address - Phone:850-576-4073
Practice Address - Fax:850-576-6849
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43191207L00000X
FLME98320208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002292000Medicaid
FLME98320OtherSTATE LICENSE
CA00A431910Medicaid
CA00A431910Medicaid
FL002292000Medicaid