MEDICARE: DR. NAOMI C CHAO PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY14523	CA

General Provider Information

NPI Number	:	1427046168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAOMI C CHAO PH.D.

Provider Business Mailing Address
First Line	:	1224 SANTA ANITA AVE
Second Line	:	SUITE B1
City	:	S EL MONTE
State	:	CA
Zip	:	91733-3842
Country	:	US
Telephone Number	:	626-688-1275
Fax Number	:	951-827-2015

Provider Business Practice Location Address
First Line	:	1224 SANTA ANITA AVE
Second Line	:	SUITE B1
City	:	S EL MONTE
State	:	CA
Zip	:	91733-3842
Country	:	US
Telephone Number	:	626-688-1275
Fax Number	:	951-827-2015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	07/08/2007

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