Provider Demographics
NPI:1881362945
Name:ADVANCED SURGICAL CARE AND WELLNESS CENTER CHU PC
Entity type:Organization
Organization Name:ADVANCED SURGICAL CARE AND WELLNESS CENTER CHU PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:KIMBERLY
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-789-7050
Mailing Address - Street 1:1500 E 2ND ST STE 206
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1198
Mailing Address - Country:US
Mailing Address - Phone:775-789-7065
Mailing Address - Fax:
Practice Address - Street 1:1500 E 2ND ST STE 206
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1198
Practice Address - Country:US
Practice Address - Phone:775-789-7065
Practice Address - Fax:775-789-7038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty