Provider Demographics
NPI:1609036417
Name:CHIONG, BRIAN BOBBY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:BOBBY
Last Name:CHIONG
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 1:301 DIAMOND ST APT D
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2879
Mailing Address - Country:US
Mailing Address - Phone:626-230-9234
Mailing Address - Fax:
Practice Address - Street 1:301 DIAMOND ST APT D
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2879
Practice Address - Country:US
Practice Address - Phone:626-230-9234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-15
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1263862085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology