Provider Demographics
NPI:1437437415
Name:CHIANG, CAROLE ISHAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:ISHAN
Last Name:CHIANG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 S GOLDEN WEST AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-6563
Mailing Address - Country:US
Mailing Address - Phone:626-241-6266
Mailing Address - Fax:
Practice Address - Street 1:2100 FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-2905
Practice Address - Country:US
Practice Address - Phone:909-596-1941
Practice Address - Fax:909-596-1943
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4959213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery