MEDICARE: AMY TIEN-TSUEN CHU O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	10304TPL	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528050093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY TIEN-TSUEN CHU O.D.

Provider Business Mailing Address
First Line	:	21851 AVALON BLVD
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-3304
Country	:	US
Telephone Number	:	310-830-0632
Fax Number	:	310-830-9827

Provider Business Practice Location Address
First Line	:	21851 AVALON BLVD
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-3304
Country	:	US
Telephone Number	:	310-830-0632
Fax Number	:	310-830-9827

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	04/28/2010

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