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Individual
MARK C CHUA
Active
Individual
MARK C CHUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95008812
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95008812
BOARD OF REGISTERED NURSING
CA
Enumeration date
09/17/2019
Last updated
09/17/2019
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