Healthcare Provider Details

I. General information

NPI: 1205368537
Provider Name (Legal Business Name): JUSTIN CHUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date: 04/06/2020
Reactivation Date: 04/29/2020

III. Provider practice location address

250 HOSPITAL PKWY
SAN JOSE CA
95119-1103
US

IV. Provider business mailing address

250 HOSPITAL PKWY
SAN JOSE CA
95119-1103
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-3000
  • Fax:
Mailing address:
  • Phone: 408-972-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA206788
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: