Provider Demographics
NPI:1811308083
Name:TONY T CHI DMD INC
Entity type:Organization
Organization Name:TONY T CHI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:562-436-8294
Mailing Address - Street 1:123 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5121
Mailing Address - Country:US
Mailing Address - Phone:562-436-8294
Mailing Address - Fax:562-437-2195
Practice Address - Street 1:123 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-5121
Practice Address - Country:US
Practice Address - Phone:562-436-8294
Practice Address - Fax:562-437-2195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37202284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital