Healthcare Provider Details

I. General information

NPI: 1780621755
Provider Name (Legal Business Name): ANDREW YUH CHAO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11411 BROOKSHIRE AVE STE 207
DOWNEY CA
90241-5004
US

IV. Provider business mailing address

11411 BROOKSHIRE AVE STE 207
DOWNEY CA
90241-5004
US

V. Phone/Fax

Practice location:
  • Phone: 562-904-4411
  • Fax: 562-904-5353
Mailing address:
  • Phone: 562-904-4411
  • Fax: 562-904-5353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR2A51
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A4859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: