Provider Demographics
NPI:1871270066
Name:CHU, RICHIE VY
Entity type:Individual
Prefix:
First Name:RICHIE
Middle Name:VY
Last Name:CHU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8682 HATTERAS DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-7024
Mailing Address - Country:US
Mailing Address - Phone:760-622-3666
Mailing Address - Fax:
Practice Address - Street 1:1855 ALUM ROCK AVE STE C
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1398
Practice Address - Country:US
Practice Address - Phone:408-254-7524
Practice Address - Fax:408-426-9970
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator