Individual
CHARLES CHIANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5757 HARPER DR NE, ALBUQUERQUE, NM 87109-3566
(505) 888-5757
(505) 865-0160
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 246-2622
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD2004-0711
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04104722
—
NM
05
—
926389
—
AZ
01
—
NM009U33
BC BS OF NM
NM
01
—
P00201687
MEDICARE ID
NM
Enumeration date
08/01/2005
Last updated
10/22/2024
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