Provider Demographics
NPI:1780692145
Name:CHU, EVANGELINE D (MD)
Entity type:Individual
Prefix:
First Name:EVANGELINE
Middle Name:D
Last Name:CHU
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:361 HOSPITAL RD
Mailing Address - Street 2:SUITE 223
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3522
Mailing Address - Country:US
Mailing Address - Phone:949-650-0341
Mailing Address - Fax:949-650-6235
Practice Address - Street 1:361 HOSPITAL RD
Practice Address - Street 2:STE 223
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3511
Practice Address - Country:US
Practice Address - Phone:949-650-0341
Practice Address - Fax:949-650-6235
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG84146207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
330854107Medicare ID - Type Unspecified
G12205Medicare UPIN