Provider Demographics
NPI:1154855765
Name:CHIANG, KATHERINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 E PLAZA BLVD
Mailing Address - Street 2:SUITE L
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-5161
Mailing Address - Country:US
Mailing Address - Phone:619-267-0768
Mailing Address - Fax:
Practice Address - Street 1:2220 E PLAZA BLVD
Practice Address - Street 2:SUITE L
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-5161
Practice Address - Country:US
Practice Address - Phone:619-267-0768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 51269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist