Provider Demographics
NPI:1386810133
Name:CHIOU, PHILIP (NONE) (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:(NONE)
Last Name:CHIOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17923 CECELIA PL
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8713
Mailing Address - Country:US
Mailing Address - Phone:949-445-3778
Mailing Address - Fax:562-689-0078
Practice Address - Street 1:2840 LONG BEACH BLVD
Practice Address - Street 2:SUITE 465
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1516
Practice Address - Country:US
Practice Address - Phone:562-595-0790
Practice Address - Fax:562-689-0078
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2015-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106763208VP0014X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA106763OtherMEDICAL BOARD PHYSICIAN LICENSE NUMBER
CA12302718OtherCAQH PROVIDER NUMBER
CAA106763OtherMEDICAL BOARD PHYSICIAN LICENSE NUMBER