Individual provider Active NPI

Joseph Chua

  • Registered Nurse
  • Riverside, CA
National Provider Identifier
1972104990
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
640845 Issued in CA
Practice address
11350 River Knoll Dr
Riverside, CA 92505-5148
Phone
(909) 645-0213
NPI assigned
Nov 5, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 640845 CA Primary

Addresses

Primary practice location

11350 River Knoll Dr
Riverside, CA 92505-5148

Mailing address

11350 River Knoll Dr
Riverside, CA 92505-5148
Phone (909) 645-0213

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
640845CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1972104990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 RIVER KNOLL DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925055148",
            "telephone_number": "909-645-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 RIVER KNOLL DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925055148",
            "telephone_number": "909-645-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "640845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.