Healthcare Provider Details

I. General information

NPI: 1073481156
Provider Name (Legal Business Name): TIFFANY CHIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7403 HELLMAN AVE
ROSEMEAD CA
91770-2213
US

IV. Provider business mailing address

9825 MILOANN ST
TEMPLE CITY CA
91780-3926
US

V. Phone/Fax

Practice location:
  • Phone: 626-280-6161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number86372707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: