Provider Demographics
NPI:1871024943
Name:JUAN, CHIH-YANG (DO)
Entity Type:Individual
Prefix:
First Name:CHIH-YANG
Middle Name:
Last Name:JUAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:JUAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:9500 EUCLID AVE # A-21
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-448-0218
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # A-21
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1971
Practice Address - Country:US
Practice Address - Phone:216-448-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.0157002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program