Healthcare Provider Details

I. General information

NPI: 1326009275
Provider Name (Legal Business Name): WILLY NG CHUA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N ROSE DR STE 102
PLACENTIA CA
92870-3800
US

IV. Provider business mailing address

75 STRAWBERRY GRV
IRVINE CA
92620-2305
US

V. Phone/Fax

Practice location:
  • Phone: 714-577-2124
  • Fax:
Mailing address:
  • Phone: 786-229-1336
  • Fax: 305-545-5220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME054079
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA50664
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: