Provider Demographics
NPI:1790585966
Name:CHUA, AIMEE DIONE SUSON (RD)
Entity type:Individual
Prefix:
First Name:AIMEE DIONE
Middle Name:SUSON
Last Name:CHUA
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 IROLO ST APT 307
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-2385
Mailing Address - Country:US
Mailing Address - Phone:310-890-1106
Mailing Address - Fax:
Practice Address - Street 1:741 IROLO ST APT 307
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-2385
Practice Address - Country:US
Practice Address - Phone:310-890-1106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86377162133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered