Healthcare Provider Details

I. General information

NPI: 1811328164
Provider Name (Legal Business Name): PHILIP CHIOU MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ODYSSEY STE 270B
IRVINE CA
92618-3186
US

IV. Provider business mailing address

17923 CECELIA PL
CERRITOS CA
90703-8713
US

V. Phone/Fax

Practice location:
  • Phone: 949-431-2668
  • Fax:
Mailing address:
  • Phone: 949-445-3778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA106763
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA106763
License Number StateCA

VIII. Authorized Official

Name: PHILIP CHIOU
Title or Position: PRESIDENT
Credential: MD
Phone: 949-445-3778