Provider Demographics
NPI:1326590761
Name:HER, PANG CHIA (PA-C, NP-C)
Entity Type:Individual
Prefix:
First Name:PANG
Middle Name:CHIA
Last Name:HER
Suffix:
Gender:F
Credentials:PA-C, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 DORAX DR
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-7813
Mailing Address - Country:US
Mailing Address - Phone:530-680-3726
Mailing Address - Fax:
Practice Address - Street 1:2780 ORO DAM BLVD E
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-5192
Practice Address - Country:US
Practice Address - Phone:530-538-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005294363LF0000X
CA53959363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily