Healthcare Provider Details
I. General information
NPI: 1598315467
Provider Name (Legal Business Name): DEAN T. CHIANG, M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2019
Last Update Date: 05/24/2020
Certification Date: 05/24/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3440 LOMITA BLVD STE 228
TORRANCE CA
90505-4870
US
IV. Provider business mailing address
10 COUNTRY MEADOW RD
ROLLING HILLS ESTATES CA
90274-5776
US
V. Phone/Fax
- Phone: 310-508-0578
- Fax:
- Phone: 310-508-0578
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DEAN
CHIANG
Title or Position: PRESIDENT
Credential: MD
Phone: 310-508-0578