Provider Demographics
NPI:1568523751
Name:FANG, CHI-HUA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:CHI-HUA
Middle Name:MARIA
Last Name:FANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39159 PASEO PADRE PKWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1608
Mailing Address - Country:US
Mailing Address - Phone:510-505-1091
Mailing Address - Fax:510-505-1111
Practice Address - Street 1:1220 ROSSMOOR PKWY
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-2501
Practice Address - Country:US
Practice Address - Phone:925-939-1220
Practice Address - Fax:925-977-8112
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG67095207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G670953Medicare PIN