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General NPI Number Information
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NPI Number | 1891865267
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Entity Type | Organization
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Legal Business Name | KATIE W. CHU, O.D., INC.
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3106 SAN GABRIEL BLVD UNIT H
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City | ROSEMEAD
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State | CA
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Zip | 91770-2579
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Country | US
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Telephone | 626-288-6278
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Fax | 626-571-1868
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Provider Business Mailing Address
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Address Line | 3106 SAN GABRIEL BLVD UNIT H
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City | ROSEMEAD
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State | CA
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Zip | 91770-2579
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Country | US
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Telephone | 626-288-6278
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Fax | 626-571-1868
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATIE WANKAY CHU
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Credential | O.D.
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Telephone | 626-298-0790
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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 | COR 1116
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License Number State | CA
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