Healthcare Provider Details

I. General information

NPI: 1992257018
Provider Name (Legal Business Name): MICHAEL W CHU, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 K ST STE 209
SACRAMENTO CA
95816-5124
US

IV. Provider business mailing address

2901 K ST STE 209
SACRAMENTO CA
95816-5124
US

V. Phone/Fax

Practice location:
  • Phone: 916-744-2627
  • Fax: 916-737-5226
Mailing address:
  • Phone: 916-744-2627
  • Fax: 916-737-5226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA93972
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL WENIN CHU
Title or Position: CEO
Credential: MD
Phone: 916-744-2627