Provider Demographics
NPI:1306173398
Name:HOPE MEDICAL GROUP
Entity type:Organization
Organization Name:HOPE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:323-622-8970
Mailing Address - Street 1:2099 S ATLANTIC BLVD STE I
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-6355
Mailing Address - Country:US
Mailing Address - Phone:323-622-8970
Mailing Address - Fax:323-271-4801
Practice Address - Street 1:2099 S ATLANTIC BLVD STE I
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-6355
Practice Address - Country:US
Practice Address - Phone:323-622-8970
Practice Address - Fax:323-271-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1285957639Medicare UPIN
CA1982640413Medicare UPIN
1043227804Medicare UPIN