Provider Demographics
NPI:1821863457
Name:JOHN Y. CHA, DPM, INC.
Entity Type:Organization
Organization Name:JOHN Y. CHA, DPM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:310-672-5893
Mailing Address - Street 1:500 S SEPULVEDA BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6977
Mailing Address - Country:US
Mailing Address - Phone:310-991-8210
Mailing Address - Fax:310-376-7810
Practice Address - Street 1:500 S SEPULVEDA BLVD STE 303
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6977
Practice Address - Country:US
Practice Address - Phone:310-991-8210
Practice Address - Fax:310-376-7810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric