Basic Information
| Provider Information | |||||||||
| NPI: | 1841251105 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHUDY | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1850 GATEWAY BLVD | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945203279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008820686 | ||||||||
| FaxNumber: | 9259384969 | ||||||||
| Practice Location | |||||||||
| Address1: | 4001 HIGHWAY 104 | ||||||||
| Address2: | |||||||||
| City: | IONE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2092744911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2006 | ||||||||
| LastUpdateDate: | 03/09/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G47843 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207QA0401X | G47843 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine |
No ID Information.