Provider Demographics
NPI:1538572243
Name:CHU, ANDREW PHUC (DPM)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:PHUC
Last Name:CHU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:820 CANYON WASH DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-2062
Mailing Address - Country:US
Mailing Address - Phone:714-500-8650
Mailing Address - Fax:
Practice Address - Street 1:18800 MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1717
Practice Address - Country:US
Practice Address - Phone:714-841-1963
Practice Address - Fax:714-841-6919
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA6675213E00000X
CAE5378213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist