Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A90536 | CA |
N | 208600000X | Surgeon | A90536 | CA |
Y | 2086S0129X | Vascular Surgeon | A90536 | CA |
NPI | 1063514321 |
---|---|
Provider Name | Alexander B Chao |
First Address | Encinitas, CA 92024-2380 |
Second Address | San Diego, CA 92134-1098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 24/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I46010 | (02) | CA |