=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932440575
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. YU CHIN CHIU PODIATRY CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2013
-----------------------------------------------------
Last Update Date | 03/06/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10516 LOWER AZUSA RD
-----------------------------------------------------
City | EL MONTE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91731-1209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-443-2020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10516 LOWER AZUSA RD
-----------------------------------------------------
City | EL MONTE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91731-1209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-443-2020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. YU-CHIN CHIU
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 626-443-2020
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0131X
-----------------------------------------------------
Taxonomy Name | Foot Surgery Podiatrist
-----------------------------------------------------
License Number | E4642
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------