Provider Demographics
NPI:1851323794
Name:CHIU, SHIN CHUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIN
Middle Name:CHUNG
Last Name:CHIU
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 1:11480 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:562-861-7800
Mailing Address - Fax:562-861-8500
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
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA22236174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA22297Medicare UPIN
CAA22236Medicare PIN