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General NPI Number Information
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NPI Number | 1396991402
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Entity Type | Individual
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Provider Name | EDWARD CHU O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2008
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Last Update Date | 05/01/2017
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Provider Practice Location Address
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Address Line | 5901 E 7TH ST BRC BUILDING 166, 2ND FLOOR, OPTOMETRY SERVICE
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City | LONG BEACH
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State | CA
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Zip | 90822-5201
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Country | US
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Telephone | 844-808-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 221 COMPASS
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City | IRVINE
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State | CA
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Zip | 92618-1154
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Country | US
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Telephone | 949-861-3191
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG002113
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13585
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License Number State | CA
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