Basic Information
Provider Information
NPI: 1003058827
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHA
FirstName: CATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CHOI
OtherFirstName: CATHERINE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3103018707
FaxNumber: 3103018751
Practice Location
Address1: 757 WESTWOOD PLZ
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900958358
CountryCode: US
TelephoneNumber: 3108258041
FaxNumber: 3102673766
Other Information
ProviderEnumerationDate: 03/25/2009
LastUpdateDate: 07/17/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA110568CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home