Pengta Anthony Chiang, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A61358 Issued in CA

Practice address

4002 Vista Way
Emergency Department
Oceanside, CA 92056-4506

Phone

(760) 439-1963

Fax

(760) 268-0931

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Team Physicians of Southern California Medical Group, Inc.

  • Emergency Medicine Physician
  • Oceanside, CA
  • NPI 1225499015
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1104892710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 AVENIDA ENCINAS",
            "address_2": "STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920084381",
            "telephone_number": "760-439-1963",
            "fax_number": "760-268-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 VISTA WAY",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564506",
            "telephone_number": "760-439-1963",
            "fax_number": "760-268-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIANG",
        "first_name": "PENGTA",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A61358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A613580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Kay Cherevka
• Ashley N Chestnut, DPT
• Shane T. Chestnut, B.A.
• Leiana-Richelle Cheung
• Stephanie Cheung, PHARMD
• Hellen Chiao, MD
• Joy Marie Childers, RN
• Kathleen Brigid Chiodo, DDS. MSD
• Megan Chiriboga, NP
• Karen Louise Chisholm, OD

• Emergency Medicine Physician in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.