Healthcare Provider Details

I. General information

NPI: 1144403593
Provider Name (Legal Business Name): JOHN Y. CHA, DPM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 E REGENT ST
INGLEWOOD CA
90301-1415
US

IV. Provider business mailing address

656 E REGENT ST
INGLEWOOD CA
90301-1415
US

V. Phone/Fax

Practice location:
  • Phone: 310-672-5893
  • Fax: 310-672-1825
Mailing address:
  • Phone: 310-672-5893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE3929
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberE3929
License Number StateCA

VIII. Authorized Official

Name: DR. JOHN Y CHA
Title or Position: OWNER
Credential: DPM
Phone: 310-672-5893