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General NPI Number Information
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NPI Number | 1437437415
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Entity Type | Individual
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Provider Name | CAROLE ISHAN CHIANG D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2011
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 2100 FOOTHILL BLVD STE A
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City | LA VERNE
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State | CA
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Zip | 91750-2905
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Country | US
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Telephone | 909-596-1941
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Fax | 909-596-1943
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Provider Business Mailing Address
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Address Line | 822 S GOLDEN WEST AVE UNIT A
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City | ARCADIA
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State | CA
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Zip | 91007-6563
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Country | US
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Telephone | 626-241-6266
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Fax |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4959
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License Number State | CA
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