Provider Demographics
NPI:1679645311
Name:SHIN C. CHIU M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SHIN C. CHIU M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-928-6776
Mailing Address - Street 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:STE 203A
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5018
Mailing Address - Country:US
Mailing Address - Phone:562-928-6776
Mailing Address - Fax:562-928-6669
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:STE 203A
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5018
Practice Address - Country:US
Practice Address - Phone:562-928-6776
Practice Address - Fax:562-928-6669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty