Provider Demographics
NPI:1780889519
Name:CHIANG, CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:CHIANG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:39465 PASEO PADRE PKWY STE 2600
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1631
Mailing Address - Country:US
Mailing Address - Phone:510-456-2390
Mailing Address - Fax:510-456-2380
Practice Address - Street 1:1860 MOWRY AVE STE 304
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1730
Practice Address - Country:US
Practice Address - Phone:510-456-2390
Practice Address - Fax:510-456-2380
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2024-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA104751207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHH304ZMedicare UPIN