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General NPI Number Information
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NPI Number | 1225263312
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Entity Type | Organization
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Legal Business Name | DENNIS A. CHUCK M.D. INC.
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 1774 ALAMEDA ST
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City | POMONA
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State | CA
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Zip | 91768-1727
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Country | US
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Telephone | 909-622-1188
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Fax | 909-623-4768
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Provider Business Mailing Address
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Address Line | 1774 ALAMEDA ST
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City | POMONA
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State | CA
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Zip | 91768-1727
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Country | US
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Telephone | 909-622-1188
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Fax | 909-623-4768
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Authorized Official
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Title or Position | MEDICAL BILLER
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Name | MS. CARMELINDA VILLA
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Credential |
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Telephone | 909-622-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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