Basic Information
Provider Information
NPI: 1932555828
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TUNG
FirstName: CHIA HSIANG
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6301 S MCCLINTOCK DR STE 1
Address2:  
City: TEMPE
State: AZ
PostalCode: 852833392
CountryCode: US
TelephoneNumber: 4802142300
FaxNumber: 4802132301
Practice Location
Address1: 2550 E GUADALUPE RD STE 115
Address2:  
City: GILBERT
State: AZ
PostalCode: 852345114
CountryCode: US
TelephoneNumber: 4806321544
FaxNumber: 4806321533
Other Information
ProviderEnumerationDate: 05/10/2016
LastUpdateDate: 07/17/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X57808AZY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


Home