Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | PA51593 | CA |
NPI | 1134309099 |
---|---|
Provider Name | Yong Chua |
First Address | Rancho Santa Margarita, CA 92688-2804 |
Second Address | Mission Viejo, CA 92691-6426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 24/10/2020 |