Provider Demographics
NPI:1043846728
Name:KAWAKAMI, CHIA-LING GAU (PHD, ABMGG, NYCOQ,)
Entity Type:Individual
Prefix:
First Name:CHIA-LING
Middle Name:GAU
Last Name:KAWAKAMI
Suffix:
Gender:F
Credentials:PHD, ABMGG, NYCOQ,
Other - Prefix:
Other - First Name:CHIA-LING
Other - Middle Name:
Other - Last Name:GAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, ABMGG, NYCOQ
Mailing Address - Street 1:15 ARGONAUT
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1423
Mailing Address - Country:US
Mailing Address - Phone:949-900-5514
Mailing Address - Fax:
Practice Address - Street 1:15 ARGONAUT
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-1423
Practice Address - Country:US
Practice Address - Phone:949-900-5514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYGAUXC1207SG0203X
CADRN-01002018207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics