Provider Demographics
NPI:1922459106
Name:CHIANG, BEVERLEY
Entity Type:Individual
Prefix:
First Name:BEVERLEY
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 GLADSTONE DR STE 4
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5126
Mailing Address - Country:US
Mailing Address - Phone:650-245-5749
Mailing Address - Fax:
Practice Address - Street 1:2240 GLADSTONE DR STE 4
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5126
Practice Address - Country:US
Practice Address - Phone:650-245-5749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program