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NPI Code Detail

MEDICARE: BENJAMIN VAL CHU PA-C

MEDICARE: BENJAMIN VAL CHU PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantC50000833DE
2363AS0400XSurgical Physician AssistantPA9108012FL
3363AS0400XSurgical Physician AssistantPA195088OR

General Provider Information

NPI Number : 1326390121
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN VAL CHU PA-C
Provider Business Mailing Address
First Line : 1775 THOMPSON RD
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2198
Country : US
Telephone Number : 541-269-8111
Fax Number :
Provider Business Practice Location Address
First Line : 1775 THOMPSON RD
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2198
Country : US
Telephone Number : 541-269-8111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2012
Last Update Date : 01/08/2024

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Directions to “ BENJAMIN VAL CHU PA-C” Practice Location

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