Provider Demographics
NPI:1275907842
Name:STEPHANIE C. CHA, M.D. INC.
Entity Type:Organization
Organization Name:STEPHANIE C. CHA, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-688-9900
Mailing Address - Street 1:PO BOX 2757
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92859-0757
Mailing Address - Country:US
Mailing Address - Phone:714-973-2650
Mailing Address - Fax:714-973-2655
Practice Address - Street 1:4081 E OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-3330
Practice Address - Country:US
Practice Address - Phone:323-261-0809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111403207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty