Provider Demographics
NPI:1043276363
Name:CHIANG, JULIAN LEE-WEN (MD)
Entity type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:LEE-WEN
Last Name:CHIANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIAN
Other - Middle Name:LEEWEN
Other - Last Name:CHIANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:236 VALLEY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1650
Mailing Address - Country:US
Mailing Address - Phone:805-218-8815
Mailing Address - Fax:805-221-6989
Practice Address - Street 1:1600 N ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3722
Practice Address - Country:US
Practice Address - Phone:805-218-8815
Practice Address - Fax:805-221-6989
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38967207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0020840Medicaid
CAWA38967BMedicare PIN
CAGR0020840Medicaid