Healthcare Provider Details

I. General information

NPI: 1457858805
Provider Name (Legal Business Name): RAYMOND FRANCIS CHUA II DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15955 PARAMOUNT BLVD STE A
PARAMOUNT CA
90723-5144
US

IV. Provider business mailing address

15955 PARAMOUNT BLVD STE A
PARAMOUNT CA
90723-5144
US

V. Phone/Fax

Practice location:
  • Phone: 562-531-9806
  • Fax:
Mailing address:
  • Phone: 562-531-9806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: