Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A106244 | CA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A106244 | CA |
NPI | 1619118494 |
---|---|
Provider Name | Bob Chiang |
First Address | Bradbury, CA 91008-1131 |
Second Address | Bradbury, CA 91008-1131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2009 |
Last Update Date | 12/03/2021 |