Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 1727 | CA |
N | 1223G0001X | General Practice | 63100 | CA |
N | 213EG0000X | General Practice | 63100 | CA |
NPI | 1780095216 |
---|---|
Provider Name | Dr. Christopher T Chiu |
First Address | San Ramon, CA 94583-5381 |
Second Address | San Leandro, CA 94577-4207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2014 |
Last Update Date | 08/03/2021 |