Healthcare Provider Details

I. General information

NPI: 1285686592
Provider Name (Legal Business Name): PAO Y. CHIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 WILSHIRE BLVD
LOS ANGELES CA
90017-2395
US

IV. Provider business mailing address

17117 LEAL AVE
CERRITOS CA
90703-1337
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-2423
  • Fax:
Mailing address:
  • Phone: 213-268-4168
  • Fax: 213-268-4168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA82770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: