MEDICARE: DR. CHIA-YU TENG M.D.

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	207R00000X	Internal Medicine Physician	G69120	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00G691200	OTHER	CA	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	00G691200	OTHER	CA	BLUE CROSS

General Provider Information

NPI Number	:	1902839160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIA-YU TENG M.D.

Provider Business Mailing Address
First Line	:	18575 GALE AVE STE 235
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91748-1383
Country	:	US
Telephone Number	:	626-810-7708
Fax Number	:	626-810-7002

Provider Business Practice Location Address
First Line	:	18575 GALE AVE STE 235
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91748-1383
Country	:	US
Telephone Number	:	626-810-7708
Fax Number	:	626-810-7002

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	02/27/2020

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