Individual
LISA DIANE CHODAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4987 GOLDEN FOOTHILL PKWY, EL DORADO HILLS, CA 95762-9364
(916) 933-4222
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C52473
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000810818782
PHCS
CA
01
—
00C524730
BLUE SHIELD
CA
05
—
00C524730
—
CA
01
—
0926165
CIGNA
CA
01
—
1268871
GREAT WEST
CA
01
—
133086
HEALTH NET
CA
01
—
309748
INTERPLAN
CA
01
—
5228393
FIRST HEALTH
CA
01
—
5890742
AETNA
CA
01
—
90206061
PACIFICARE
CA
01
—
C52473
BLUE CROSS
CA
01
—
MCMG491300
WESTERN HEALTH ADVANTAGE
CA
Enumeration date
09/14/2006
Last updated
02/09/2012
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