Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 62627 | CA |
NPI | 1053744177 |
---|---|
Provider Name | Dr. Kevin Chiang |
First Address | Anaheim, CA 92801-6503 |
Second Address | Anaheim, CA 92801-4621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2013 |
Last Update Date | 14/07/2021 |