Individual provider Active NPI

Bor-Han Chiu, D.O.

  • Infectious Disease Physician
  • Los Angeles, CA
National Provider Identifier
1306239470
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
20A15498 Issued in CA
Practice address
11103 Venice Blvd
Los Angeles, CA 90034-6914
Phone
(310) 734-8526
NPI assigned
Mar 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A15498 CA
Infectious Disease Physician 207RI0200X 20A15498 CA Primary

Addresses

Primary practice location

11103 Venice Blvd
Los Angeles, CA 90034-6914

Mailing address

11103 Venice Blvd
Los Angeles, CA 90034-6914

Other practice location 1

155 N Fresno St
Fresno, CA 93701
Phone (559) 499-6500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190722000766 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 2466758933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11103 Venice Blvd
Los Angeles, CA 90034-6914
Phone (323) 673-8168

Hospital & facility affiliations

  • Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739
  • Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104
  • Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20A15498CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minghsun Liu, M.D., PC Infectious Disease CurrentSince May 29, 2019 Accepting new patients
Bor-Han Chiu, DO, PC Infectious Disease CurrentSince Jul 1, 2020 Accepting new patients
Duke Health Lake Norman Regional Medical Center, Inc. Past Accepting new patients

Locations

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1306239470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 VENICE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11103 VENICE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346914",
            "telephone_number": "310-734-8526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 N Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93701",
            "country_code": "US",
            "telephone_number": "559-499-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIU",
        "first_name": "BOR-HAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-12",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A15498",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "20A15498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.