Individual
DR. THA CHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 E BARSTOW AVE STE 118, FRESNO, CA 93710-5023
(559) 486-5290
(559) 486-5630
Mailing address
125 E BARSTOW AVE STE 118, FRESNO, CA 93710-5023
(559) 486-5290
(559) 486-5630
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A84894
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
A84894
CA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A84894
CA
Other
Enumeration date
07/10/2006
Last updated
04/29/2011
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