Healthcare Provider Details

I. General information

NPI: 1962664565
Provider Name (Legal Business Name): DR. CHRISTOPHER Y CHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 E WALNUT ST 3RD FLOOR
PASADENA CA
91188-0001
US

IV. Provider business mailing address

393 E WALNUT ST 3RD FLOOR
PASADENA CA
91188-0001
US

V. Phone/Fax

Practice location:
  • Phone: 888-505-0043
  • Fax:
Mailing address:
  • Phone: 888-505-0043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA110381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: