Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 20A17403 | CA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 20A17403 | CA |
N | 2081P2900X | Pain Medicine | 20A17403 | CA |
NPI | 1154718815 |
---|---|
Provider Name | Michael Chu |
First Address | Hemet, CA 92543-3083 |
Second Address | Hemet, CA 92543-3083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2015 |
Last Update Date | 17/12/2021 |