Provider Demographics
NPI:1528076742
Name:YEH-TO, CHIA C (MD)
Entity type:Individual
Prefix:
First Name:CHIA
Middle Name:C
Last Name:YEH-TO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 894830
Mailing Address - Street 2:LOCK BOX 4830
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90189-4830
Mailing Address - Country:US
Mailing Address - Phone:702-360-2100
Mailing Address - Fax:909-557-1924
Practice Address - Street 1:6700 N 1ST ST
Practice Address - Street 2:STE 131
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3900
Practice Address - Country:US
Practice Address - Phone:559-432-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103769207NS0135X
IL036-109565207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109565Medicaid
IL08232205OtherBLUE CROSS BLUE SHIELD
IL0008232086OtherBLUECROSS BLUESHIELD
CA00A1037692Medicare PIN
IL036109565Medicaid
CAWA103769JMedicare PIN
CAWA103769CMedicare PIN
CAWA103769HMedicare PIN
CA00A103695Medicare PIN
IL08232205OtherBLUE CROSS BLUE SHIELD
CAWA103769FMedicare PIN
CAWA103769GMedicare PIN
CAWA103769KMedicare PIN
CA00A1037690Medicare PIN
CAWA103769DMedicare PIN
CAWA103769EMedicare PIN
CAWA103769IMedicare PIN
CA00A1037693Medicare PIN
CA00A1037691Medicare PIN
IL0008232086OtherBLUECROSS BLUESHIELD
CAAQ177YMedicare PIN
CAWA103769AMedicare PIN
H96659Medicare UPIN
ILK30289Medicare PIN