Healthcare Provider Details

I. General information

NPI: 1164611695
Provider Name (Legal Business Name): JASON HAN CHUA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 W LA PALMA AVE STE 301
ANAHEIM CA
92801-2811
US

IV. Provider business mailing address

PO BOX 5486
ORANGE CA
92863-5486
US

V. Phone/Fax

Practice location:
  • Phone: 594-969-7717
  • Fax:
Mailing address:
  • Phone: 818-550-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA99735
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: