Provider Demographics
NPI:1982799169
Name:CHIANG, CHRISTINA YI (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:YI
Last Name:CHIANG
Suffix:
Gender:F
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:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-5356
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:201 CEDAR SE 5TH FLOOR SUITE 5600
Practice Address - Street 2:PMG CEDAR OBGYN
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-563-6000
Practice Address - Fax:505-563-6060
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM9927207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000Z7376Medicaid
G99856Medicare UPIN
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