Provider Demographics
NPI:1528280906
Name:CHIANG, MICHAEL CHUNG HOU (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHUNG HOU
Last Name:CHIANG
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 1:7365 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2508
Mailing Address - Country:US
Mailing Address - Phone:323-807-2733
Mailing Address - Fax:
Practice Address - Street 1:3364 E SLAUSON AVE
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CA
Practice Address - Zip Code:90058-3915
Practice Address - Country:US
Practice Address - Phone:323-807-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH07186Medicare UPIN