Provider Demographics
NPI:1568523751
Name:FANG, CHI-HUA MARIA (MD)
Entity type:Individual
Prefix:
First Name:CHI-HUA
Middle Name:MARIA
Last Name:FANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 437
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30292-0437
Mailing Address - Country:US
Mailing Address - Phone:510-505-1091
Mailing Address - Fax:510-505-1111
Practice Address - Street 1:1870 TICE VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-2224
Practice Address - Country:US
Practice Address - Phone:925-299-9100
Practice Address - Fax:925-233-1023
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2024-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG67095207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G670953Medicare PIN