Provider Demographics
NPI:1376897231
Name:JULIAN L CHIANG MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:JULIAN L CHIANG MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:LEE-WEN
Authorized Official - Last Name:CHIANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-988-6688
Mailing Address - Street 1:1801 SOLAR DR
Mailing Address - Street 2:SUITE 251
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-8234
Mailing Address - Country:US
Mailing Address - Phone:805-988-6688
Mailing Address - Fax:805-221-6989
Practice Address - Street 1:1801 SOLAR DR
Practice Address - Street 2:SUITE 251
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-8234
Practice Address - Country:US
Practice Address - Phone:805-988-6688
Practice Address - Fax:805-221-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39867207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA38967BMedicare PIN