Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 56692 | CA |
NPI | 1073835385 |
---|---|
Provider Name | Dr. Ching Hsiu Ketty Chiu |
First Address | Temple City, CA 91780-1123 |
Second Address | Los Angeles, CA 90089-0058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2010 |
Last Update Date | 16/03/2021 |