=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265535686
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J. CHU-HSIANG CHI, M.D. INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/07/2006
-----------------------------------------------------
Last Update Date | 04/30/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17777 CRENSHAW BOULEVARD SUITE 102
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90504-4120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-715-2858
-----------------------------------------------------
Fax | 310-325-8688
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2255 W 230TH ST
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-5208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-325-8437
-----------------------------------------------------
Fax | 310-325-8688
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | CHU-HSIANG CHI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 310-715-2858
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | A37803
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------