Basic Information
| Provider Information | |||||||||
| NPI: | 1942268149 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHUANG | ||||||||
| FirstName: | TSU-YI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 275 N EL CIELO RD | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922626972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603208814 | ||||||||
| FaxNumber: | 7607701608 | ||||||||
| Practice Location | |||||||||
| Address1: | 69844 HIGHWAY 111 | ||||||||
| Address2: | SUITE A | ||||||||
| City: | RANCHO MIRAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922702849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603184869 | ||||||||
| FaxNumber: | 7607701608 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207NS0135X | C50711 | CA | N | Allopathic & Osteopathic Physicians | Dermatology | Procedural Dermatology | 207N00000X | C50711 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
ID Information
| ID | Type | State | Issuer | Description | 271689700 | 05 | FL | MEDICAID |