MEDICARE: CHRISTINE H PAO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	62236	CA

General Provider Information

NPI Number	:	1225260268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE H PAO LCSW

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD SUITE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-5631
Country	:	US
Telephone Number	:	310-301-8707
Fax Number	:	310-301-8751

Provider Business Practice Location Address
First Line	:	300 UCLA MEDICAL PLZ STE 2200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-2204
Country	:	US
Telephone Number	:	310-825-9989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	05/25/2021

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