Provider Demographics
NPI:1215965355
Name:CHU, PAUL TIAT-FAT (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:TIAT-FAT
Last Name:CHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:728 PACIFIC AVE
Mailing Address - Street 2:#405
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-4457
Mailing Address - Country:US
Mailing Address - Phone:415-788-3370
Mailing Address - Fax:415-788-0946
Practice Address - Street 1:728 PACIFIC AVE
Practice Address - Street 2:#405
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4457
Practice Address - Country:US
Practice Address - Phone:415-788-3370
Practice Address - Fax:415-788-0946
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42212207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA29529Medicare UPIN