Provider Demographics
NPI:1407102031
Name:JEE, AGNES CHIANG (MD)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:CHIANG
Last Name:JEE
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 1:133 N ALTADENA DR FL 2
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-7325
Mailing Address - Country:US
Mailing Address - Phone:626-397-8300
Mailing Address - Fax:
Practice Address - Street 1:301 W HUNTINGTON DR STE 320
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-1500
Practice Address - Country:US
Practice Address - Phone:626-447-3516
Practice Address - Fax:626-447-8546
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120459208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics