Provider Demographics
NPI:1598957458
Name:CHA, HEA IN (MD)
Entity Type:Individual
Prefix:
First Name:HEA
Middle Name:IN
Last Name:CHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEAIN
Other - Middle Name:
Other - Last Name:CHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:533 CANTOR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3842
Mailing Address - Country:US
Mailing Address - Phone:310-259-4952
Mailing Address - Fax:
Practice Address - Street 1:533 CANTOR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3842
Practice Address - Country:US
Practice Address - Phone:310-259-4952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103655208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics