Provider Demographics
NPI:1154681435
Name:CHIAO, HELLEN (MD)
Entity Type:Individual
Prefix:
First Name:HELLEN
Middle Name:
Last Name:CHIAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3923 WARING RD STE A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4499
Mailing Address - Country:US
Mailing Address - Phone:760-724-8872
Mailing Address - Fax:760-842-7801
Practice Address - Street 1:3923 WARING RD STE A
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056
Practice Address - Country:US
Practice Address - Phone:760-724-8782
Practice Address - Fax:760-842-7801
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127722207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1154681435Medicaid