Provider Demographics
NPI:1902245111
Name:CHU, ANTHONY (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:CHU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5627 TELEGRAPH AVE STE 179
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1707
Mailing Address - Country:US
Mailing Address - Phone:213-537-9912
Mailing Address - Fax:
Practice Address - Street 1:5627 TELEGRAPH AVE STE 179
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1707
Practice Address - Country:US
Practice Address - Phone:213-537-9912
Practice Address - Fax:657-250-7349
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14731207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine