Provider Demographics
NPI:1730392556
Name:CHU, STALIN (DDS)
Entity type:Individual
Prefix:DR
First Name:STALIN
Middle Name:
Last Name:CHU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WESTBOROUGH BLVD.
Mailing Address - Street 2:SUITE 105A
Mailing Address - City:SO. SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-5402
Mailing Address - Country:US
Mailing Address - Phone:650-737-7907
Mailing Address - Fax:650-737-5921
Practice Address - Street 1:2400 WESTBOROUGH BLVD.
Practice Address - Street 2:SUITE 105A
Practice Address - City:SO. SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5402
Practice Address - Country:US
Practice Address - Phone:650-737-7907
Practice Address - Fax:650-737-5921
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice