Basic Information
| Provider Information | |||||||||
| NPI: | 1245959048 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CHU | ||||||||
| FirstName: | CHRISTINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10351 SAMOA AVE | ||||||||
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| City: | TUJUNGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910421919 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 11460 W WASHINGTON BLVD | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900666030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103377115 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2022 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 23984 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.