Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | A80333 | CA |
NPI | 1184702763 |
---|---|
Provider Name | Edison Chiu |
First Address | Oakland, CA 94612-3466 |
Second Address | Santa Clara, CA 95051-5329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 23/12/2021 |