Organization Active NPI

William C. Chu, MD, Incorporated

  • Diagnostic Radiology Physician
  • Glendora, CA
National Provider Identifier
1639259377
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
WILLIAM C. CHU, MD, INCORPORATED
Practice address
150 W Route 66
Radiology Department
Glendora, CA 91740-6207
Phone
(626) 335-0231
Fax
(626) 821-0406
NPI assigned
Oct 17, 2006
Last updated
Nov 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William C. Chu, MDNPI 1124018551
Title
President
Phone
(626) 335-0231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary
Vascular & Interventional Radiology Physician 2085R0204X NU
Diagnostic Ultrasound Physician 2085U0001X NU

Addresses

Primary practice location

150 W Route 66
Radiology Department
Glendora, CA 91740-6207

Mailing address

PO Box 18989
Anaheim, CA 92817-8989
Phone (626) 821-1411

Other identifiers 2

IdentifierTypeStateIssuer
00A388582OtherCABLUE SHIELD
00A388582MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070928000607 CA Part B Supplier - Clinic/Group Practice 8325133887 Receives reassigned benefits from 1 practitioner
Practice locations: Baldwin Park, CA; Needles, CA

National Provider Directory

National Provider Directory
Tax ID family
Pacific Alliance Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1639259377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18989",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928178989",
            "telephone_number": "626-821-1411",
            "fax_number": "626-821-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W ROUTE 66",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406207",
            "telephone_number": "626-335-0231",
            "fax_number": "626-821-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM C. CHU, MD, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-335-0231",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A388582",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A388582",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.