MEDICARE: CLARA BOO CHAI PA

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	363A00000X	Physician Assistant	1174414	CA

General Provider Information

NPI Number	:	1770192759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARA BOO CHAI PA

Provider Business Mailing Address
First Line	:	1650 COCHRANE CIR # B7500
Second Line	:
City	:	FT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIR # B7500
Second Line	:
City	:	FT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:	719-524-7282
Fax Number	:

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

Provider Enumeration Date	:	07/27/2020
Last Update Date	:	02/02/2026

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Directions to “ CLARA BOO CHAI PA” Practice Location

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