Provider Demographics
NPI:1356123491
Name:CHUANG, CHU YUNG (RD)
Entity type:Individual
Prefix:
First Name:CHU YUNG
Middle Name:
Last Name:CHUANG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:CHUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:9941 GARIBALDI AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-1716
Mailing Address - Country:US
Mailing Address - Phone:626-321-5092
Mailing Address - Fax:
Practice Address - Street 1:9941 GARIBALDI AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-1716
Practice Address - Country:US
Practice Address - Phone:626-321-5092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86297071133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered