Healthcare Provider Details

I. General information

NPI: 1952051625
Provider Name (Legal Business Name): ANDREA CHRISTINE CHIANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 TECHNOLOGY DR DEPT 345
SAN JOSE CA
95110-1305
US

IV. Provider business mailing address

1721 TECHNOLOGY DR DEPT 345
SAN JOSE CA
95110-1305
US

V. Phone/Fax

Practice location:
  • Phone: 408-436-4400
  • Fax:
Mailing address:
  • Phone: 408-436-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number202620
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: