Basic Information
| Provider Information | |||||||||
| NPI: | 1104279348 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHIU | ||||||||
| FirstName: | JEFF | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 GALAXY WAY STE 400 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945205725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254828402 | ||||||||
| FaxNumber: | 9254822825 | ||||||||
| Practice Location | |||||||||
| Address1: | 851 S BACOM AVE | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4088855000 | ||||||||
| FaxNumber: | 5137154076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2016 | ||||||||
| LastUpdateDate: | 07/31/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A15789 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 20A15789 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.