Individual
DR. JESSE JEN-CHIEH CHUANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
207 S SANTA ANITA STREET STE G18, SAN GABRIEL, CA 91776-1147
(626) 427-1490
Mailing address
PO BOX 989, ALHAMBRA, CA 91802-0989
(626) 427-1490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A93456
CA
207RN0300X
Nephrology Physician
Primary
A93456
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A93456
MEDICAL BOARD CERTIFICATE
CA
01
—
BM108W
MEDICARE PTAN
—
Enumeration date
07/13/2006
Last updated
11/30/2021
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