Provider Demographics
NPI:1205279106
Name:CHIEN, KUANG-CHUNG HU (MD)
Entity type:Individual
Prefix:DR
First Name:KUANG-CHUNG
Middle Name:HU
Last Name:CHIEN
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 1:9445 LA JOLLA FARMS RD
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1128
Mailing Address - Country:US
Mailing Address - Phone:858-622-0888
Mailing Address - Fax:
Practice Address - Street 1:9445 LA JOLLA FARMS RD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1128
Practice Address - Country:US
Practice Address - Phone:858-622-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50354208000000X
CAA5035A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice