Active NPI
Dennis Alphonsus G Chua, OTR/L
- Gerontology Occupational Therapist
- Beaumont, CA
National Provider Identifier
1306163746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Occupational Therapist
- License
- 12463
- Practice address
- 1326 Melstone St
Beaumont, CA 92223-3258 - Phone
- (909) 901-3100
- NPI assigned
- Apr 26, 2010
- Last updated
- Feb 3, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | 46TR00515700 | NJ | |
| Gerontology Occupational Therapist | 225XG0600X | 12463 | CA | Primary |
Addresses
Primary practice location
1326 Melstone St
Beaumont, CA 92223-3258
Mailing address
1326 Melstone St
Beaumont, CA 92223-3258
Phone (909) 901-3100
Other names 1
- Dennis Alphonsus G Reyes Chua
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12463 | CA | MD | Professional Counselor |
| 46TR00515700 | NJ | MD | Gerontology Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643846400000",
"number": "1306163746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1326 MELSTONE ST",
"city": "BEAUMONT",
"state": "CA",
"postal_code": "922233258",
"telephone_number": "909-901-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1326 MELSTONE ST",
"city": "BEAUMONT",
"state": "CA",
"postal_code": "922233258",
"telephone_number": "909-901-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUA",
"first_name": "DENNIS ALPHONSUS",
"middle_name": "G",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-26",
"last_updated": "2022-02-03",
"certification_date": "2022-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "NJ",
"license": "46TR00515700",
"primary": false
},
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "CA",
"license": "12463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DENNIS ALPHONSUS G",
"last_name": "CHUA",
"middle_name": "REYES",
"credential": "OTD, OTR/L, CAPS",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Beaumont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.