Provider Demographics
NPI:1194107938
Name:CHUANG, DAVID (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CHUANG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 PENNINGTON LN
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4930
Mailing Address - Country:US
Mailing Address - Phone:408-786-7677
Mailing Address - Fax:
Practice Address - Street 1:317 LOS GATOS SARATOGA RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5310
Practice Address - Country:US
Practice Address - Phone:650-731-2562
Practice Address - Fax:855-877-7015
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2020-05-07
Deactivation Date:2018-07-26
Deactivation Code:
Reactivation Date:2018-08-22
Provider Licenses
StateLicense IDTaxonomies
CAE5438213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist