=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326009275
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLY NG CHUA MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2006
-----------------------------------------------------
Last Update Date | 03/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1325 N ROSE DR STE 102
-----------------------------------------------------
City | PLACENTIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92870-3800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-577-2124
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 75 STRAWBERRY GRV
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92620-2305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-229-1336
-----------------------------------------------------
Fax | 305-545-5220
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | ME054079
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | A50664
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------