Basic Information
| Provider Information | |||||||||
| NPI: | 1063640829 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHUA | ||||||||
| FirstName: | LESLIE ANNE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 9TH AVE | ||||||||
| Address2: | MS:M4-PFS | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981012756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065155811 | ||||||||
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| Practice Location | |||||||||
| Address1: | 133 ROUTE 3 | ||||||||
| Address2: | |||||||||
| City: | DEDEDO | ||||||||
| State: | GU | ||||||||
| PostalCode: | 969296911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6716455500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2009 | ||||||||
| LastUpdateDate: | 05/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD60607762 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 25MA09137300 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | M-2049 | GU | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | M-2049 | GU | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.