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Individual

CHARITO CHUA GO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
981225 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-5075
(402) 836-9288
(402) 559-8940
Mailing address
981225 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-1225
(402) 836-9288
(402) 559-8940

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
21065
OK
208100000X
Physical Medicine & Rehabilitation Physician
K5960
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0464885-07
IND TPI
TX
05
046488505
TX
05
200823140A
OK
01
2035487-02
GROUP TPI
TX
01
317142YMNO
MEDICARE PTAN
TX
01
8DW142
BCBS
TX
01
TXB102731
GROUP PTAN
TX
Enumeration date
06/09/2006
Last updated
05/09/2023
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