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General NPI Number Information
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NPI Number | 1003606617
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Entity Type | Individual
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Provider Name | VIVIAN CHU PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 120 W HELLMAN AVE STE 101
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City | MONTEREY PARK
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State | CA
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Zip | 91754-1209
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Country | US
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Telephone | 626-893-2760
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Fax |
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Provider Business Mailing Address
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Address Line | 2880 GARONA DR
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-6646
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Country | US
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Telephone | 626-893-2760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 66353
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License Number State | CA
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