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General NPI Number Information
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NPI Number | 1932302908
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Entity Type | Individual
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Provider Name | MARK CHU PT
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Gender | Male
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 531 W COLLEGE ST
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City | LOS ANGELES
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State | CA
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Zip | 90012-2315
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Country | US
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Telephone | 626-683-9390
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Fax |
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Provider Business Mailing Address
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Address Line | 3340 MARTHA CIR
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City | PASADENA
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State | CA
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Zip | 91107-5534
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Country | US
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Telephone | 626-585-1828
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 29376
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License Number State | CA
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