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General NPI Number Information
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NPI Number | 1306163746
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Entity Type | Individual
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Provider Name | DENNIS ALPHONSUS G CHUA OTR/L
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Gender | Male
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1326 MELSTONE ST
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City | BEAUMONT
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State | CA
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Zip | 92223-3258
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Country | US
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Telephone | 909-901-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 1326 MELSTONE ST
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City | BEAUMONT
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State | CA
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Zip | 92223-3258
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Country | US
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Telephone | 909-901-3100
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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 | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 46TR00515700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 12463
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License Number State | CA
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