Healthcare Provider Details

I. General information

NPI: 1447817861
Provider Name (Legal Business Name): CHIM MEE YANG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 10/12/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 WATER ST STE A
SANTA CRUZ CA
95060-4126
US

IV. Provider business mailing address

550 WATER ST STE A
SANTA CRUZ CA
95060-4126
US

V. Phone/Fax

Practice location:
  • Phone: 831-476-4414
  • Fax: 831-476-0264
Mailing address:
  • Phone: 831-476-4414
  • Fax: 831-476-0264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number20A22276
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number20A22276
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: