Provider Demographics
NPI:1295778819
Name:CHIA, LI-LI SUBRINA (MD)
Entity type:Individual
Prefix:DR
First Name:LI-LI
Middle Name:SUBRINA
Last Name:CHIA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:15785 LAGUNA CANYON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3165
Mailing Address - Country:US
Mailing Address - Phone:949-753-1163
Mailing Address - Fax:949-753-1949
Practice Address - Street 1:15785 LAGUNA CANYON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3165
Practice Address - Country:US
Practice Address - Phone:949-753-1163
Practice Address - Fax:949-753-1949
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2010-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG53672207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE89844Medicare UPIN
0213740001Medicare NSC
CAG53672Medicare PIN