Healthcare Provider Details

I. General information

NPI: 1649216136
Provider Name (Legal Business Name): JASON CHECHEN CHU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MAX DR SUITE 102
CASTLE PINES CO
80108-9517
US

IV. Provider business mailing address

250 MAX DR SUITE 102
CASTLE PINES CO
80108-9517
US

V. Phone/Fax

Practice location:
  • Phone: 303-649-3350
  • Fax: 303-649-3351
Mailing address:
  • Phone: 303-649-3350
  • Fax: 303-649-3351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number44810
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: