Individual
DR. IMOK CHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
250 BON AIR ROAD, GREENBRAE, CA 94904
(415) 925-7174
(415) 898-0870
Mailing address
1615 HILL ROAD, SUITE B, NOVATO, CA 94947
(415) 898-7649
(415) 898-0870
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G73632
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G736321
—
CA
Enumeration date
08/25/2006
Last updated
07/08/2007
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