Provider Demographics
NPI:1053322701
Name:CHIEN, MAI-CHING (MD)
Entity Type:Individual
Prefix:
First Name:MAI-CHING
Middle Name:
Last Name:CHIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 E LATHAM AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4391
Mailing Address - Country:US
Mailing Address - Phone:951-766-1954
Mailing Address - Fax:
Practice Address - Street 1:850 E LATHAM AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4391
Practice Address - Country:US
Practice Address - Phone:951-766-1954
Practice Address - Fax:951-766-7750
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43947207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A439470Medicaid
CAE42623Medicare UPIN
CA00A439470Medicaid