Provider Demographics
NPI:1497248033
Name:CHA, CHUAH (DO)
Entity Type:Individual
Prefix:
First Name:CHUAH
Middle Name:
Last Name:CHA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16233 KING ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:CA
Mailing Address - Zip Code:95315-9460
Mailing Address - Country:US
Mailing Address - Phone:209-850-3500
Mailing Address - Fax:
Practice Address - Street 1:16233 KING ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:CA
Practice Address - Zip Code:95315-9460
Practice Address - Country:US
Practice Address - Phone:209-850-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA17803207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine