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NPI Code Detail

MEDICARE: SOON M. CHA, M.D., INC.

MEDICARE: SOON M. CHA, M.D., INC.
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
1207V00000XObstetrics & Gynecology PhysicianA39746CA

General Provider Information

NPI Number : 1891944633
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOON M. CHA, M.D., INC.
Provider Business Mailing Address
First Line : 1058 S VERMONT AVE
Second Line : SUITE 204
City : LOS ANGELES
State : CA
Zip : 90006-2721
Country : US
Telephone Number : 213-368-6020
Fax Number : 213-927-0504
Provider Business Practice Location Address
First Line : 1058 S VERMONT AVE
Second Line : SUITE 204
City : LOS ANGELES
State : CA
Zip : 90006-2721
Country : US
Telephone Number : 213-368-6020
Fax Number : 213-927-0504
Authorized Official
Title or Position : PRESIDENT
Name : SOON M. CHA
Credential : M.D.
Telephone Number : 213-368-6020
Provider Enumeration Date : 09/17/2008
Last Update Date : 09/17/2008

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