Individual provider Active NPI

Tin Thanh Chu, MD

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1922748862
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A198862 Issued in CA
Practice address
4343 Market St Ste C
Riverside, CA 92501-3567
Phone
(951) 784-7406
NPI assigned
Mar 30, 2022
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X A198862 CA Primary

Addresses

Primary practice location

4343 Market St Ste C
Riverside, CA 92501-3567

Mailing address

4343 Market St Ste C
Riverside, CA 92501-3567
Phone (951) 784-7406

Other practice location 1

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3366

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
I20250711003059 CA Practitioner - Family Practice 0941715619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bolsa Medical GroupGroup PAC ID 2769458264, 14 clinicians
Good Samaritan Medical Group IncGroup PAC ID 5799224226, 3 clinicians

Practice addresses (Care Compare)

10362 Bolsa Ave
Suite 110
Westminster, CA 92683-6763
Phone (714) 531-2091

4343 Market St
Suite C
Riverside, CA 92501-3567
Phone (951) 784-7406

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A198862CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Medical Group Inc. Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Bolsa Medical Group Family Medicine CurrentSince Jul 9, 2025 Accepting new patients
Bolsa Medical Group PastSince Jul 9, 2025 Accepting new patients

Locations

4343 Market St
Ste C
Riverside, CA 92501
Phone (951) 248-0485

10362 Bolsa Ave
Westminster, CA 92683
Phone (714) 531-2091

10362 Bolsa Ave
Ste 110
Westminster, CA 92683
Phone (714) 531-2091

10362 Bolsa Ave
Ste 206
Westminster, CA 92683

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tinthanh.chu@bolsamg.directbygreenway.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1922748862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 MARKET ST STE C",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013567",
            "telephone_number": "951-784-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 MARKET ST STE C",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013567",
            "telephone_number": "951-784-7406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-3366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHU",
        "first_name": "TIN",
        "middle_name": "THANH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A198862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.