Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | NP 95003241 | CA |
NPI | 1003289299 |
---|---|
Provider Name | Ching-Yi Chiu |
First Address | Bell Gardens, CA 90201 |
Second Address | Bell Gardens, CA 90201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2015 |
Last Update Date | 10/11/2015 |