Basic Information
Provider Information
NPI: 1255639175
EntityType: 2
ReplacementNPI:  
OrganizationName: VINCENT CHIU MD INC
LastName:  
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Mailing Information
Address1: PO BOX 788
Address2:  
City: HEMET
State: CA
PostalCode: 925460788
CountryCode: US
TelephoneNumber: 9519296260
FaxNumber: 9517652855
Practice Location
Address1: 207 W LEGION RD
Address2:  
City: BRAWLEY
State: CA
PostalCode: 922277780
CountryCode: US
TelephoneNumber: 9519296260
FaxNumber: 9517652855
Other Information
ProviderEnumerationDate: 03/01/2011
LastUpdateDate: 03/01/2011
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: CHIU
AuthorizedOfficialFirstName: VINCENT
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 9519296260
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XG81878CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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