Healthcare Provider Details

I. General information

NPI: 1386810133
Provider Name (Legal Business Name): PHILIP (NONE) CHIOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 06/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 LONG BEACH BLVD SUITE 465
LONG BEACH CA
90806-1516
US

IV. Provider business mailing address

17923 CECELIA PL
CERRITOS CA
90703-8713
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-0790
  • Fax: 562-689-0078
Mailing address:
  • Phone: 949-445-3778
  • Fax: 562-689-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA106763
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA106763
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: