Organization
NOEL TD CHIU MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOEL CHIU M.D. (OWNER)
(925) 754-6767
Entity
Organization
Contact information
Practice address
3436 HILLCREST AVE, SUITE 150, ANTIOCH, CA 94531-6304
(925) 754-6767
(925) 754-0137
Mailing address
PO BOX 1312, ALAMO, CA 94507-7312
(925) 754-6767
(925) 754-0137
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A75814
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A75814
CA
207ND0900X
Dermatopathology Physician
A75814
CA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
A75814
CA
207NP0225X
Pediatric Dermatology Physician
A75814
CA
207NS0135X
Procedural Dermatology Physician
A75814
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A758140
—
CA
01
—
ZZZ65527Z
BLUE SHIELD ID
CA
Enumeration date
07/09/2006
Last updated
09/30/2014
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