Healthcare Provider Details

I. General information

NPI: 1265476428
Provider Name (Legal Business Name): GABRIEL SAMUEL CHUA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL DR STE 304
VALLEJO CA
94589-2583
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 707-427-4900
  • Fax: 707-551-3641
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCA49399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: