Provider Demographics
NPI:1902839160
Name:TENG, CHIA-YU (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIA-YU
Middle Name:
Last Name:TENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18575 GALE AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1383
Mailing Address - Country:US
Mailing Address - Phone:626-810-7708
Mailing Address - Fax:626-810-7002
Practice Address - Street 1:18575 GALE AVE STE 235
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1383
Practice Address - Country:US
Practice Address - Phone:626-810-7708
Practice Address - Fax:626-810-7002
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69120207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G691200OtherBLUE SHIELD
CA00G691201Medicaid
CA00G691200OtherBLUE CROSS
CA00G691201Medicaid
F19774Medicare UPIN