Individual provider Active NPI

Wah Wah Chu, MD

  • Internal Medicine Physician
  • Palmdale, CA
National Provider Identifier
1891018719
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A110341 Issued in CA
Practice address
38636 Medical Center Dr Ste C
Palmdale, CA 93551-4689
Phone
(661) 273-0100
NPI assigned
Mar 5, 2010
Last updated
Feb 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A110341 CA Primary

Addresses

Primary practice location

38636 Medical Center Dr Ste C
Palmdale, CA 93551-4689

Mailing address

44469 10TH St W
Lancaster, CA 93534-3324
Phone (661) 945-9411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000541 CA Practitioner - Internal Medicine 2163616954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Medical Group Holding Company, Inc. Internal Medicine CurrentSince Sep 1, 2010 Accepting new patients
Radadvantage a Professional Corporation PastSince Sep 1, 2010 Accepting new patients

Locations

44469 10th St W
Lancaster, CA 93534
Phone (661) 945-9411

39115 Trade Center Dr
Palmdale, CA 93551
Phone (661) 223-3880

39115 Trade Center Dr
Ste 130
Palmdale, CA 93551
Phone (661) 273-0100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1891018719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44469 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343324",
            "telephone_number": "661-945-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38636 MEDICAL CENTER DR STE C",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514689",
            "telephone_number": "661-273-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "WAH WAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A110341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.