Provider Demographics
NPI:1346342102
Name:CHAU, CYNTHIA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:CHAU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 CLEVELAND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1652
Mailing Address - Country:US
Mailing Address - Phone:213-624-4574
Mailing Address - Fax:
Practice Address - Street 1:1000 E DOMINGUEZ ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3600
Practice Address - Country:US
Practice Address - Phone:310-715-7755
Practice Address - Fax:310-366-7711
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14986363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical