Provider Demographics
NPI:1144403593
Name:JOHN Y. CHA, DPM, INC
Entity type:Organization
Organization Name:JOHN Y. CHA, DPM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:310-672-5893
Mailing Address - Street 1:656 E REGENT ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1415
Mailing Address - Country:US
Mailing Address - Phone:310-672-5893
Mailing Address - Fax:
Practice Address - Street 1:656 E REGENT ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1415
Practice Address - Country:US
Practice Address - Phone:310-672-5893
Practice Address - Fax:310-672-1825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP1100X
CAE3929332B00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E39290Medicaid
CA000E39290Medicaid
CAW22345Medicare PIN
CA4668660001Medicare NSC