Provider Demographics
NPI:1255663852
Name:DR. LAWRENCE L CHAO PROFESSIONAL COROPERATION
Entity Type:Organization
Organization Name:DR. LAWRENCE L CHAO PROFESSIONAL COROPERATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:415-333-3302
Mailing Address - Street 1:2645 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1633
Mailing Address - Country:US
Mailing Address - Phone:415-333-3302
Mailing Address - Fax:415-692-8688
Practice Address - Street 1:124 THRIFT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2921
Practice Address - Country:US
Practice Address - Phone:415-713-9787
Practice Address - Fax:415-452-9373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-06
Last Update Date:2010-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18045261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care