Provider Demographics
NPI:1780297663
Name:CHIAO, PING-HSUAN (DPT)
Entity type:Individual
Prefix:
First Name:PING-HSUAN
Middle Name:
Last Name:CHIAO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DAPHNE
Other - Middle Name:
Other - Last Name:CHIAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3030 SAWTELLE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-1408
Mailing Address - Country:US
Mailing Address - Phone:310-390-9018
Mailing Address - Fax:310-390-0868
Practice Address - Street 1:1824 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4937
Practice Address - Country:US
Practice Address - Phone:626-375-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT298943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist