MEDICARE: DR. JASON J CHIU M.D.

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
1	207X00000X	Orthopaedic Surgery Physician	A62291	CA

General Provider Information

NPI Number	:	1962400440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON J CHIU M.D.

Provider Business Mailing Address
First Line	:	10212 WESTMINSTER AVENUE
Second Line	:	SUITE 102
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10212 WESTMINSTER AVENUE
Second Line	:	SUITE 102
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4800
Country	:	US
Telephone Number	:	714-210-1718
Fax Number	:	714-210-1720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	06/01/2012

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