Provider Demographics
NPI:1629363320
Name:CHAO, WAN-KAI (PT)
Entity Type:Individual
Prefix:
First Name:WAN-KAI
Middle Name:
Last Name:CHAO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 E LOS COYOTES DIAGONAL APT 7
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2841
Mailing Address - Country:US
Mailing Address - Phone:626-446-3168
Mailing Address - Fax:626-446-8699
Practice Address - Street 1:650 W DUARTE RD
Practice Address - Street 2:168
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7617
Practice Address - Country:US
Practice Address - Phone:626-446-3168
Practice Address - Fax:626-446-8699
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT37756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist