Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 234002 | MA |
NPI | 1013199868 |
---|---|
Provider Name | Gary S Chuang |
First Address | Redondo Beach, CA 90277-2870 |
Second Address | Torrance, CA 90503-5800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2007 |
Last Update Date | 17/03/2018 |