Healthcare Provider Details

I. General information

NPI: 1700466893
Provider Name (Legal Business Name): ISAAC CHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 S MOONEY BLVD
VISALIA CA
93277-6228
US

IV. Provider business mailing address

400 E OAK AVE
VISALIA CA
93291-5034
US

V. Phone/Fax

Practice location:
  • Phone: 877-960-3426
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA63868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: