Provider Demographics
NPI:1427421577
Name:CHAO, PETER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:CHAO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18543 YORBA LINDA BLVD # 230
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4135
Mailing Address - Country:US
Mailing Address - Phone:714-889-9000
Mailing Address - Fax:
Practice Address - Street 1:3943 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5440
Practice Address - Country:US
Practice Address - Phone:909-590-7597
Practice Address - Fax:909-590-9692
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA739441835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care