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General NPI Number Information
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NPI Number | 1295753655
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Entity Type | Individual
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Provider Name | WEN-YUAN MARIEANNE CHIANG D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 9844 ATLANTIC AVE SUITE #A
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City | SOUTH GATE
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State | CA
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Zip | 90280-5219
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Country | US
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Telephone | 310-631-3502
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Fax | 310-631-5143
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Provider Business Mailing Address
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Address Line | PO BOX 3547
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City | CERRITOS
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State | CA
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Zip | 90703-3547
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Country | US
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Telephone | 310-631-3502
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Fax | 310-631-5143
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A8521
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 20A8521
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License Number State | CA
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