Healthcare Provider Details

I. General information

NPI: 1457657710
Provider Name (Legal Business Name): CHUN HSIEN CHIANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 08/31/2024
Certification Date: 08/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N FLOWER ST DEPT OF CMS
SANTA ANA CA
92703-2361
US

IV. Provider business mailing address

505 CITY PKWY W STE 343-S
ORANGE CA
92868-2924
US

V. Phone/Fax

Practice location:
  • Phone: 949-625-0938
  • Fax: 714-752-5588
Mailing address:
  • Phone: 949-625-0938
  • Fax: 949-625-1038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA74859
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberA74859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: