Provider Demographics
NPI:1285081331
Name:CHAO, JANET C (BCO, CCA)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:C
Last Name:CHAO
Suffix:
Gender:F
Credentials:BCO, CCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3199 E WARM SPRINGS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3150
Mailing Address - Country:US
Mailing Address - Phone:702-207-9500
Mailing Address - Fax:702-852-0492
Practice Address - Street 1:3199 E WARM SPRINGS RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3150
Practice Address - Country:US
Practice Address - Phone:702-207-9500
Practice Address - Fax:702-852-0492
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1536921156FX1700X
CCA16-74229N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist
No229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologist