MEDICARE: DR. JENNIFER CHUANG DALY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	A99371	CA
2	2085R0202X	Diagnostic Radiology Physician	MD60221755	WA
3	2085R0202X	Diagnostic Radiology Physician	MD.206050	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	285026	OTHER	WA	L&I
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861724080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER CHUANG DALY MD

Provider Business Mailing Address
First Line	:	301 N HIGHWAY 190 STE C2
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-5057
Country	:	US
Telephone Number	:	985-773-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N HIGHWAY 190 STE C2
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-5057
Country	:	US
Telephone Number	:	985-773-1500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2010
Last Update Date	:	06/10/2020

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