Healthcare Provider Details

I. General information

NPI: 1518100460
Provider Name (Legal Business Name): DEBBY CHUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 AUBURN DR
BEACHWOOD OH
44122-4317
US

IV. Provider business mailing address

11100 EUCLID AVE LAKESIDE BUILDING, SUITE #4554
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35.137216
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: