Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 14889 | AZ |
NPI | 1639135320 |
---|---|
Provider Name | Dr. Edward Tsien Chu |
First Address | Phoenix, AZ 85013-3421 |
Second Address | Phoenix, AZ 85013-3421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D36676 | (02) |