Healthcare Provider Details

I. General information

NPI: 1316877483
Provider Name (Legal Business Name): CHAO K FANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 HONEYBELL LN
ESCONDIDO CA
92027-1847
US

IV. Provider business mailing address

2535 HONEYBELL LN
ESCONDIDO CA
92027-1847
US

V. Phone/Fax

Practice location:
  • Phone: 858-792-2200
  • Fax:
Mailing address:
  • Phone: 858-792-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number02015699
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number19564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: