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General NPI Number Information
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NPI Number | 1518255843
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Entity Type | Organization
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Legal Business Name | CMX CAPITAL, LLC
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 5943 FOLSOM DR
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City | LA JOLLA
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State | CA
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Zip | 92037-7326
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Country | US
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Telephone | 858-876-4253
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Fax | 858-777-5741
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Provider Business Mailing Address
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Address Line | 5580 LA JOLLA BLVD # 528
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City | LA JOLLA
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State | CA
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Zip | 92037-7651
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Country | US
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Telephone | 858-876-4253
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Fax | 858-777-5741
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Authorized Official
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Title or Position | CEO
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Name | DR. HAN SEH CHIU
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Credential | MD
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Telephone | 858-876-4253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | G-069618
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License Number State | CA
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