Provider Demographics
NPI:1861805210
Name:CHAO, JOSEPH T (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:T
Last Name:CHAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:415-600-5778
Mailing Address - Fax:415-369-1385
Practice Address - Street 1:1100 VAN NESS AVE FL 6
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6978
Practice Address - Country:US
Practice Address - Phone:415-600-5778
Practice Address - Fax:520-800-1169
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA154992207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA154992OtherSTATE MEDICAL LICENSE
CAFC7684435OtherFEDERAL DEA LICENSE