Provider Demographics
NPI:1306163746
Name:CHUA, DENNIS ALPHONSUS G (OTR/L)
Entity type:Individual
Prefix:
First Name:DENNIS ALPHONSUS
Middle Name:G
Last Name:CHUA
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:DENNIS ALPHONSUS G
Other - Middle Name:REYES
Other - Last Name:CHUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD, OTR/L, CAPS
Mailing Address - Street 1:1326 MELSTONE ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-3258
Mailing Address - Country:US
Mailing Address - Phone:909-901-3100
Mailing Address - Fax:
Practice Address - Street 1:1326 MELSTONE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-3258
Practice Address - Country:US
Practice Address - Phone:909-901-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00515700225XG0600X
CA12463225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology