Healthcare Provider Details

I. General information

NPI: 1760484455
Provider Name (Legal Business Name): DEAN TING-YUAN CHIANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 LOMITA BLVD SUITE 228
TORRANCE CA
90505-4801
US

IV. Provider business mailing address

3440 LOMITA BLVD SUITE 228
TORRANCE CA
90505-4801
US

V. Phone/Fax

Practice location:
  • Phone: 310-326-3371
  • Fax: 310-326-2294
Mailing address:
  • Phone: 310-326-3371
  • Fax: 310-326-2294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA73856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: