Provider Demographics
NPI:1366580011
Name:CHIU, REX (MD)
Entity type:Individual
Prefix:
First Name:REX
Middle Name:
Last Name:CHIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MIDDLEFIELD RD
Mailing Address - Street 2:SUITE 275
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-3500
Mailing Address - Country:US
Mailing Address - Phone:650-815-9577
Mailing Address - Fax:650-289-0166
Practice Address - Street 1:321 MIDDLEFIELD ROAD
Practice Address - Street 2:SUITE 275
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:650-815-9577
Practice Address - Fax:650-289-0166
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84116207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG59617Medicare UPIN