Provider Demographics
NPI:1881438422
Name:CHIU, PO-HAO
Entity type:Individual
Prefix:MR
First Name:PO-HAO
Middle Name:
Last Name:CHIU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 PASEO AZUL
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3990
Mailing Address - Country:US
Mailing Address - Phone:909-741-0226
Mailing Address - Fax:
Practice Address - Street 1:328 N GARFIELD AVE STE A
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1708
Practice Address - Country:US
Practice Address - Phone:909-741-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1081331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice