Provider Demographics
NPI:1730796582
Name:CHU, CRYSTAL YANFANG
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:YANFANG
Last Name:CHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9764 FLOWERET AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-6954
Mailing Address - Country:US
Mailing Address - Phone:626-376-3558
Mailing Address - Fax:
Practice Address - Street 1:9764 FLOWERET AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-6954
Practice Address - Country:US
Practice Address - Phone:626-376-3558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant