Provider Demographics
NPI:1154942761
Name:CHU, CATHERINE HUIHAN
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:HUIHAN
Last Name:CHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7481 EDINGER AVE UNIT 410
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7889
Mailing Address - Country:US
Mailing Address - Phone:858-790-9709
Mailing Address - Fax:
Practice Address - Street 1:7481 EDINGER AVE UNIT 410
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7889
Practice Address - Country:US
Practice Address - Phone:858-790-9709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZD010902122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program