MEDICARE: SHIH-TING CHIU PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC13289	CA
2	363A00000X	Physician Assistant	PA55529	CA
3	363A00000X	Physician Assistant	55529	CA
4	363AS0400X	Surgical Physician Assistant	55529	CA

General Provider Information

NPI Number	:	1164758108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIH-TING CHIU PA-C

Provider Business Mailing Address
First Line	:	6644 MOUNT WELLINGTON DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95120-1942
Country	:	US
Telephone Number	:	626-679-1345
Fax Number	:

Provider Business Practice Location Address
First Line	:	15055 LOS GATOS BLVD STE 100
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2056
Country	:	US
Telephone Number	:	408-356-1000
Fax Number	:	408-356-1125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2009
Last Update Date	:	01/23/2023

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Directions to “ SHIH-TING CHIU PA-C” Practice Location

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