1912064874 NPI number — DR. GINGER YIN CHIANG M.D.

Table of content: ANDI FU M.D. (NPI 1114287794)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912064874 NPI number — DR. GINGER YIN CHIANG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHIANG
Provider First Name:
GINGER
Provider Middle Name:
YIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JIANG
Provider Other First Name:
YIN
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1912064874
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6900 N PECOS RD STE 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89086-4400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-791-9000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6900 N. PECOS RD
Provider Second Line Business Practice Location Address:
DEPT. OF PM&R
Provider Business Practice Location Address City Name:
NORTH LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-791-9000
Provider Business Practice Location Address Fax Number:
702-224-6075
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208VP0014X , with the licence number:  15598 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2081P2900X , with the licence number: C1-0006771 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2152819000 . This is a "AMERIHEALTH" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 2119934 . This is a "MIAMSI-OPTIMUM CHOICE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 7187394 . This is a "AETNA-PPO" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1000022318 . This is a "DELAWARE PHYSICIANS CARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1000024344 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00152463 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 3149215 . This is a "AETNA-HMO" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 386606954 . This is a "BC AND BS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 9975856 . This is a "CIGNA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 188310 . This is a "COVENTRY" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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