Individual provider Active NPI

Charles Chiang, M.D

  • Dermatology Physician
  • Fremont, CA
National Provider Identifier
1780889519
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A104751 Issued in CA
Practice address
1860 Mowry Ave Ste 304
Fremont, CA 94538-1730
Phone
(510) 456-2390
Fax
(510) 456-2380
NPI assigned
Jun 20, 2007
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A104751 CA Primary

Addresses

Primary practice location

1860 Mowry Ave Ste 304
Fremont, CA 94538-1730

Mailing address

39465 Paseo Padre Pkwy Ste 2600
Fremont, CA 94538-1631
Phone (510) 456-2390

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
I20130628000753 CA Practitioner - Dermatology 9638319320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, San Diego School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berman Skin Institute Medical Group IncGroup PAC ID 0042407215, 26 clinicians

Practice addresses (Care Compare)

1860 Mowry Ave
Suite 304
Fremont, CA 94538-1730
Phone (510) 456-2390

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1155
Removal of nail tissue1-10
Removal or shaving of skin growth17
Skin biopsy189

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Berman Skin Institute Medical Group Inc Dermatology CurrentSince May 1, 2022 Accepting new patients
Healthcare Partners Affiliates Medical Group Dermatology Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jun 27, 2017 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jun 27, 2017 Accepting new patients
Jill E. Stocker, D.O. PC PastSince May 22, 2010 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

3581 Palmer Dr
Ste 203
Cameron Park, CA 95682
Phone (530) 676-0119

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

420 W Rowland St
Covina, CA 91723
Phone (626) 331-6411

1860 Mowry Ave
Ste 304
Fremont, CA 94538
Phone (510) 456-2390

39465 Paseo Padre Pkwy
Ste 2600
Fremont, CA 94538
Phone (510) 456-2390

4300 El Camino Real
Ste 100
Los Altos, CA 94022
Phone (650) 325-6000

5575 W Las Positas Blvd
Ste 220
Pleasanton, CA 94588
Phone (650) 325-6000

5575 W Las Positas Blvd
Ste 230
Pleasanton, CA 94588
Phone (925) 416-1122

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

1792 Tribute Rd
Ste 200
Sacramento, CA 95815
Phone (916) 678-5400

1 Daniel Burnham Ct
Ste 350C
San Francisco, CA 94109
Phone (415) 771-6300

100 Pringle Ave
Ste 425
Walnut Creek, CA 94596
Phone (925) 932-3800

1166 Live Oak Blvd
Yuba City, CA 95991
Phone (530) 751-1500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1780889519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39465 PASEO PADRE PKWY STE 2600",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381631",
            "telephone_number": "510-456-2390",
            "fax_number": "510-456-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 MOWRY AVE STE 304",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381730",
            "telephone_number": "510-456-2390",
            "fax_number": "510-456-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIANG",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A104751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.