Healthcare Provider Details

I. General information

NPI: 1952765034
Provider Name (Legal Business Name): ALLEN CHAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ALESSANDRO PL STE 250
PASADENA CA
91105-4006
US

IV. Provider business mailing address

50 ALESSANDRO PL STE 250
PASADENA CA
91105-4006
US

V. Phone/Fax

Practice location:
  • Phone: 626-577-1675
  • Fax: 626-577-9115
Mailing address:
  • Phone: 626-577-1675
  • Fax: 626-577-9115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA154990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: