Basic Information
| Provider Information | |||||||||
| NPI: | 1023292075 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHUA | ||||||||
| FirstName: | FE | ||||||||
| MiddleName: | CHUNG | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | LVN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1320 E WASHINGTON BLVD | ||||||||
| Address2: | APT 2 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911042531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8182676458 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6931 VAN NUYS BLVD | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189014830 | ||||||||
| FaxNumber: | 8183734830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2007 | ||||||||
| LastUpdateDate: | 12/27/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | VN230641 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.