Healthcare Provider Details

I. General information

NPI: 1093740789
Provider Name (Legal Business Name): JAMES J CHAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR MAIL CODE 8890
SAN DIEGO CA
92103-9001
US

IV. Provider business mailing address

499 N. EL CAMINO REAL, SUITE C-200 OASISMD,
ENCINITAS CA
92024
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-2696
  • Fax:
Mailing address:
  • Phone: 760-635-7800
  • Fax: 760-635-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberG85358
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: