Individual
DR. CHA CHOUKAO THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2401 W TURNER RD STE 450, LODI, CA 95242-2191
(209) 370-1700
Mailing address
1860 HOWE AVE STE 440, SACRAMENTO, CA 95825-1098
(916) 454-2345
(916) 457-2667
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A6749
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX67490
—
CA
Enumeration date
07/22/2005
Last updated
11/02/2023
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