Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 17998 | CA |
NPI | 1023242336 |
---|---|
Provider Name | Caryn Chin Chao |
First Address | Cerritos, CA 90703 |
Second Address | Cerritos, CA 90703-9329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2009 |
Last Update Date | 14/05/2009 |