Provider Demographics
NPI:1073589248
Name:CHUANG, CHAN-CHOU (MD, FCCP, FACP)
Entity Type:Individual
Prefix:DR
First Name:CHAN-CHOU
Middle Name:
Last Name:CHUANG
Suffix:
Gender:M
Credentials:MD, FCCP, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30082 AVENIDA ELEGANTE
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-4511
Mailing Address - Country:US
Mailing Address - Phone:310-265-2925
Mailing Address - Fax:310-784-4991
Practice Address - Street 1:7131 AVENIDA ALTISIMA
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-4451
Practice Address - Country:US
Practice Address - Phone:310-889-4002
Practice Address - Fax:310-265-2925
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA060989207RP1001X, 208M00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G98671Medicare UPIN