Provider Demographics
NPI:1073721569
Name:CHAO, KUANG-HWA KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:KUANG-HWA
Middle Name:KENNETH
Last Name:CHAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:K.
Other - Middle Name:KENNETH
Other - Last Name:CHAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2637 SHADELANDS DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2512
Mailing Address - Country:US
Mailing Address - Phone:925-954-6710
Mailing Address - Fax:925-954-6711
Practice Address - Street 1:575 LENNON LN
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2443
Practice Address - Country:US
Practice Address - Phone:925-954-6710
Practice Address - Fax:925-954-6711
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010805662085R0001X
CAA1048932085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA104893OtherLICENSE
CAH99980Medicare UPIN