Provider Demographics
NPI:1013150879
Name:JAME JUI YANG CHUANG, A MEDICICAL CORPORATION
Entity Type:Organization
Organization Name:JAME JUI YANG CHUANG, A MEDICICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JUI YANG
Authorized Official - Last Name:CHUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-858-0600
Mailing Address - Street 1:301 W HUNTINGTON DR STE 120
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-3487
Mailing Address - Country:US
Mailing Address - Phone:310-858-0600
Mailing Address - Fax:
Practice Address - Street 1:301 W HUNTINGTON DR STE 120
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3487
Practice Address - Country:US
Practice Address - Phone:310-858-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0496272085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A496271Medicaid
CA00A496271Medicaid