Bob Chiang MD Inc
Organization Active NPI Family Medicine Physician · Bradbury, CA
NPI 1376128124 · NPPES record last updated Mar 12, 2021
Key facts
- NPI
- 1376128124
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BOB CHIANG MD INC
- Practice address
- 7 Woodlyn LN
Bradbury, CA 91008-1131 - Phone
- (626) 818-9506
- Fax
- (626) 775-4275
- NPI assigned
- Mar 12, 2021
- Organization subpart
- No
Authorized official
- Name
- Bob Chiang, MD
- Title
- President
- Phone
- (626) 818-9506
Practitioners 1
-
Bob Chiang, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210827001996 | CA | Part B Supplier - Clinic/Group Practice | 0446655534 |
Receives reassigned benefits from 1 practitioner Practice locations: Bradbury, CA; San Bernardino, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Hospice and Palliative Medicine (Family Medicine) Physician |
207QH0002X |
Addresses
Primary practice location
7 Woodlyn LN
Bradbury, CA 91008-1131
Mailing address
7 Woodlyn LN
Bradbury, CA 91008-1131
Phone (626) 818-9506
Other providers in Bradbury, CA
All providers in Bradbury, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.