Provider Demographics
NPI:1427005891
Name:CHHIAP, VISOTH (MD)
Entity Type:Individual
Prefix:DR
First Name:VISOTH
Middle Name:
Last Name:CHHIAP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18550 DE PAUL DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2911
Mailing Address - Country:US
Mailing Address - Phone:408-779-1772
Mailing Address - Fax:408-779-1050
Practice Address - Street 1:18550 DE PAUL DR
Practice Address - Street 2:SUITE 204
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2911
Practice Address - Country:US
Practice Address - Phone:408-779-1772
Practice Address - Fax:408-779-1050
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66992207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A669922Medicare ID - Type Unspecified
CAH40473Medicare UPIN