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General NPI Number Information
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NPI Number | 1811227960
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Entity Type | Organization
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Legal Business Name | KIMBO CHIA M.D., P.C.
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 564 NIAGARA ST
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City | BUFFALO
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State | NY
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Zip | 14201-1108
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Country | US
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Telephone | 716-332-0678
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Fax | 716-332-0679
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Provider Business Mailing Address
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Address Line | 564 NIAGARA ST
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City | BUFFALO
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State | NY
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Zip | 14201-1108
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Country | US
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Telephone | 716-332-0678
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Fax | 716-332-0679
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Authorized Official
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Title or Position | MANAGER
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Name | MR. KIMBO B CHIA
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Credential | M.D.
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Telephone | 716-332-0678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 204877NY
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License Number State | NY
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